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The outlook
THE
OUTLOOK
I43
THE OUTLOOK. THE
TUBERCULOSIS PROBLEM AND THE TUBERCULOSIS MOVEMENT. THE tuberculosis problerri~ increases in complexity and magnitude. Under war conditions tuberculosis has become more prevalent and damaging. Both in this country and in the lands of our Allies tuberculosis is claiming a larger number of victims. If statistical returns are to be trusted, tuberculosis is also taking heavy toll from among our enemies. As the war proceeds the mortality flom tuberculosis seems to increase. After the war tuberculosis will certainly long remain as one of the unconquered foes of mankind. \¥ar has not only led to an increase in the prevalence of tuberculosis, but it has resulted in a diminution in the activities of the tuberculosis m o v e m e n t . T h i s is g r e a tl y to be deplored, for never before was t h er e a g r eat er need for the organization and administration of measures for the p r e v e n t i o n and arrest of tuberculosis. Since the outbreak of war w e have e n d e a v o u r e d to s t im u la te research and s t r e n g t h e n scientifically directed action by the publication of a u t h o r i t a t i v e a r t i c l e s regarding various aspects of the tuberculosis problem under war conditions. 1 V~re h a v e also r e p e a t e d l y urged t h e i m p o r t a n c e of the est ab l i sh m en t of a Commission or a D e p a r t m e n t a l or I n t e r - D e p a r t m e n t a l C o m m i t t e e , which should w a t c h and study and collect evidence regai:ding all aspects of the tuberculosis question as it presents itself under w a r conditions, so that we ma~ be in a position to reconstruct or to readjust methods and measures for m a k i n g the tuberculosis m o v e m e n t m o r e scientific and s e r v ic e a b l e in its endeavours, not only under existing war conditions, but in the testing and difficult after-war days. N e a r l y four years of conflict have passed and no representative, and authoriI ative body has been established for the investigation of tuberculosis as a war problem. O u r A m e r i c a n cousins and Allies h a v e set us a fine e x a m p l e by the formation of their " C o m m i s s i o n Am4ricaine de P r 6 v e n t i o n C e n t r e la T u b e r c u l o s e en F r a n c e , " but we have not followed, s Once again we u r g e the i m p o r t a n c e of providing an approved and a u t h o r i t a t i v e body to consider a l l a s p e c t s of the tuberculosis p r o b l e m in the light c~f existing war conditions. P r o b a b l y t h e most satisfactory and effective course would be to secure the appointm e n t of an Inter-Allies Commission, s o m e w h a t on the lines of the I n t e r - A l l i e s C o m m i s s i o n on Alimentation. I n any case, it is clear that s t e p s should be taken at once, and preferably by the L o c a l G o v er n 1 The Symposium on " War and the Future of the Tuberculosis Movement " appeared in the issue of this journal for January, I916, VoI. x., No. i. The Symposium on " The Tuberculosis Movement under War and After-War Conditions" appeared in the journal for January, I917, Vol. XI., No. i. The Symposium on ~' Tuberculosis among Gombatants and War-Workers" appeared in the journal for April, i917, Vol. XI., INTo. 2. The Symposium on " T h e Arrest of Tuberculosis under War and After-War Conditions " appeared in the journal for January, I918 , Vol. ~II., No. i. The Symposium on '-' Colonies for the Tuberculous" appeared in [he journal for April, I918, Vol. XII.. No. 2. Other articles and notes which have appeared during the past four years have sought to arouse professional and public opinion to the pressing importance of the tuberculosis problem under existing conditions. ~oThe Headquarters of the " Commission Am6ricaine de Pr6vention Centre la Tuberculose en France" is at i2, Rue Boissy-d'Anglais, Paris, viii.
Ii~4
THE
BRITISH
JOURNAL:
OF
TUBERCULOSIS
m e n t Bogrd, to secure the a p p o i n t m e n t of a t h o r o u g h l y r e p r e s e n t a t i v e C o m m i t t e e c a p a b l e of dealing with all a s p e c t s of the tuberculosis p r o b l e m under war and after-,var conditions. Such a committee should obtain the assistance o f e x p e r t Commissioners, a n d e v e r y endeavour should b e m a d e to gain the co-operation of those ha,ring experience in m e t h o d s o f research, clinical investigation, organization, and a d m i n i s t r a t i o n , a n d every branch of medico+sociological study a n d service. T h e tuberculosis p r o b l e m m u s t be m e t and studied here and nmg if success is to a t t e n d the' tuberculosis m o v e m e n t in the coming years. W e shall be glad to receive expressions of opinion as to t h e w a y s and m e a n s b y which t h e c o m m o n d e s i r e . m a y b e best furthered. NOTES
AND RECORDS.
W e have received a n u m b e r of v a l u a b l e reports, and regret t h a t lack of space' m a k e s it impossible for t h e m to be dealt with as t h e y deserve. T h e E l e v e n t h A n n u a l R e p o r t of the K i n g E d w a r d V I I . S a n a t o r i u m provides a v a l u a b l e series of statistical t a b l e s .giving " U l t i m a t e R e s u l t s " regarding cases which have been under t r e a t m e n t . 1 T h e T w e n t y - F i r s t A n n u a l R e p o r t of the L o o m i s S a n a t o r i u m , of which D r i H e r b e r t M a x o n K i n g is Physician-in-Chief, is a p a r t i c u l a r l y a t t r a c t i v e a n d informing document, b e a u t i f u l l y illustrated, and altogether a model production. 2 T h e F o u r t e e n t h A n n u a l R e p o r t of the Boston Association for the Relief and Control of T u b e r c u l o s i s contains a series of s t i m u l a t i n g addresses and p a r t i c u l a r s r e g a r d i n g the development of the work of the AssociationY T h e A m e r i c a n N a t i o n a l Association for the S t u d y and P r e v e n t i o n of T u b e r c u l o s i s has wisely shortened and c o n c e n t r a t e d its name. I n future, this most progressive of bodies dealing with tuberculosis will be kcmwn as the , " N a t i o n a l T u b e r c u l o s i s Ass%ciation. ''4 W e have received communications from the Hon. S e c r e t a r y of the T u b e r c u l o s i s D i s p e n s a r y Care Association, i, L o n d o n Street, Reading, and t h e Clerk o f the I n s u r a n c e C o m m i t t e e for the B o r o u g h of R e a d i n g , B r o a d w a y Buildings, S t a t i o n Road, R e a d i n g , i n t i m a t i n g that a h a n d b o o k is in p r e p a r a t i o n dealing with the w o r k of After-Care C o m m i t t e e s in E n g l a n d , and inviting i n f o r m a t i o n likely to be of service in t h e production of such a work. A Course of P o s t - G r a d u a t e S t u d y on S u r g i c a l T u b e r c u l o s i s will be held at the L o r d M a y o r T r e l o a r Cripples' H o s p i t a l and College at Alton, H u n t s , from Monday, J u l y 29, to S a t u r d a y , A u g u s t 3, inclusive. N o fee will be charged, and lunch and tea will be provided. F u l l particulars m a y be obtained on application beirgg m a d e to Dr. H . J. G a u v a i n , the M e d i c a l S u p e r i n t e n d e n t . 1 Copies of the Eleventh Annum Report of King Edward VII. Sanatorium Midhurst. dealing with the period July, I916, to July, I917. can be obtained on application to the Medical Superintendent+ Price is. post free. The Twenty-First Annual Report of the Loomis Sanatorium for the Treatment of Tuberculosis, at Liberty, Sulli, an County, New York, is published at the Sanatorium, and copies may be obtained on application. a The Fourteenth Annual Report of the Boston Association for the Relief and Control%f Tuberculosis is published at the Central Offices 3, Joy Street , Boston. Mass., U.S.A. 4 The Headquarters of the American National Association for the Stud~y and ]~revention of Tuberculosis have for some time been situated at the United Charities Building, lO5, East 22nd Street. New York. In future the Headquarters of the American Natic,nal Tuberculosis As.-ociation will be at 38, Fourth Avenue. New York City, UJS~A.
OUTLOOK
I43
THE OUTLOOK. THE
TUBERCULOSIS PROBLEM AND THE TUBERCULOSIS MOVEMENT. THE tuberculosis problerri~ increases in complexity and magnitude. Under war conditions tuberculosis has become more prevalent and damaging. Both in this country and in the lands of our Allies tuberculosis is claiming a larger number of victims. If statistical returns are to be trusted, tuberculosis is also taking heavy toll from among our enemies. As the war proceeds the mortality flom tuberculosis seems to increase. After the war tuberculosis will certainly long remain as one of the unconquered foes of mankind. \¥ar has not only led to an increase in the prevalence of tuberculosis, but it has resulted in a diminution in the activities of the tuberculosis m o v e m e n t . T h i s is g r e a tl y to be deplored, for never before was t h er e a g r eat er need for the organization and administration of measures for the p r e v e n t i o n and arrest of tuberculosis. Since the outbreak of war w e have e n d e a v o u r e d to s t im u la te research and s t r e n g t h e n scientifically directed action by the publication of a u t h o r i t a t i v e a r t i c l e s regarding various aspects of the tuberculosis problem under war conditions. 1 V~re h a v e also r e p e a t e d l y urged t h e i m p o r t a n c e of the est ab l i sh m en t of a Commission or a D e p a r t m e n t a l or I n t e r - D e p a r t m e n t a l C o m m i t t e e , which should w a t c h and study and collect evidence regai:ding all aspects of the tuberculosis question as it presents itself under w a r conditions, so that we ma~ be in a position to reconstruct or to readjust methods and measures for m a k i n g the tuberculosis m o v e m e n t m o r e scientific and s e r v ic e a b l e in its endeavours, not only under existing war conditions, but in the testing and difficult after-war days. N e a r l y four years of conflict have passed and no representative, and authoriI ative body has been established for the investigation of tuberculosis as a war problem. O u r A m e r i c a n cousins and Allies h a v e set us a fine e x a m p l e by the formation of their " C o m m i s s i o n Am4ricaine de P r 6 v e n t i o n C e n t r e la T u b e r c u l o s e en F r a n c e , " but we have not followed, s Once again we u r g e the i m p o r t a n c e of providing an approved and a u t h o r i t a t i v e body to consider a l l a s p e c t s of the tuberculosis p r o b l e m in the light c~f existing war conditions. P r o b a b l y t h e most satisfactory and effective course would be to secure the appointm e n t of an Inter-Allies Commission, s o m e w h a t on the lines of the I n t e r - A l l i e s C o m m i s s i o n on Alimentation. I n any case, it is clear that s t e p s should be taken at once, and preferably by the L o c a l G o v er n 1 The Symposium on " War and the Future of the Tuberculosis Movement " appeared in the issue of this journal for January, I916, VoI. x., No. i. The Symposium on " The Tuberculosis Movement under War and After-War Conditions" appeared in the journal for January, I917, Vol. XI., No. i. The Symposium on ~' Tuberculosis among Gombatants and War-Workers" appeared in the journal for April, i917, Vol. XI., INTo. 2. The Symposium on " T h e Arrest of Tuberculosis under War and After-War Conditions " appeared in the journal for January, I918 , Vol. ~II., No. i. The Symposium on '-' Colonies for the Tuberculous" appeared in [he journal for April, I918, Vol. XII.. No. 2. Other articles and notes which have appeared during the past four years have sought to arouse professional and public opinion to the pressing importance of the tuberculosis problem under existing conditions. ~oThe Headquarters of the " Commission Am6ricaine de Pr6vention Centre la Tuberculose en France" is at i2, Rue Boissy-d'Anglais, Paris, viii.
Ii~4
THE
BRITISH
JOURNAL:
OF
TUBERCULOSIS
m e n t Bogrd, to secure the a p p o i n t m e n t of a t h o r o u g h l y r e p r e s e n t a t i v e C o m m i t t e e c a p a b l e of dealing with all a s p e c t s of the tuberculosis p r o b l e m under war and after-,var conditions. Such a committee should obtain the assistance o f e x p e r t Commissioners, a n d e v e r y endeavour should b e m a d e to gain the co-operation of those ha,ring experience in m e t h o d s o f research, clinical investigation, organization, and a d m i n i s t r a t i o n , a n d every branch of medico+sociological study a n d service. T h e tuberculosis p r o b l e m m u s t be m e t and studied here and nmg if success is to a t t e n d the' tuberculosis m o v e m e n t in the coming years. W e shall be glad to receive expressions of opinion as to t h e w a y s and m e a n s b y which t h e c o m m o n d e s i r e . m a y b e best furthered. NOTES
AND RECORDS.
W e have received a n u m b e r of v a l u a b l e reports, and regret t h a t lack of space' m a k e s it impossible for t h e m to be dealt with as t h e y deserve. T h e E l e v e n t h A n n u a l R e p o r t of the K i n g E d w a r d V I I . S a n a t o r i u m provides a v a l u a b l e series of statistical t a b l e s .giving " U l t i m a t e R e s u l t s " regarding cases which have been under t r e a t m e n t . 1 T h e T w e n t y - F i r s t A n n u a l R e p o r t of the L o o m i s S a n a t o r i u m , of which D r i H e r b e r t M a x o n K i n g is Physician-in-Chief, is a p a r t i c u l a r l y a t t r a c t i v e a n d informing document, b e a u t i f u l l y illustrated, and altogether a model production. 2 T h e F o u r t e e n t h A n n u a l R e p o r t of the Boston Association for the Relief and Control of T u b e r c u l o s i s contains a series of s t i m u l a t i n g addresses and p a r t i c u l a r s r e g a r d i n g the development of the work of the AssociationY T h e A m e r i c a n N a t i o n a l Association for the S t u d y and P r e v e n t i o n of T u b e r c u l o s i s has wisely shortened and c o n c e n t r a t e d its name. I n future, this most progressive of bodies dealing with tuberculosis will be kcmwn as the , " N a t i o n a l T u b e r c u l o s i s Ass%ciation. ''4 W e have received communications from the Hon. S e c r e t a r y of the T u b e r c u l o s i s D i s p e n s a r y Care Association, i, L o n d o n Street, Reading, and t h e Clerk o f the I n s u r a n c e C o m m i t t e e for the B o r o u g h of R e a d i n g , B r o a d w a y Buildings, S t a t i o n Road, R e a d i n g , i n t i m a t i n g that a h a n d b o o k is in p r e p a r a t i o n dealing with the w o r k of After-Care C o m m i t t e e s in E n g l a n d , and inviting i n f o r m a t i o n likely to be of service in t h e production of such a work. A Course of P o s t - G r a d u a t e S t u d y on S u r g i c a l T u b e r c u l o s i s will be held at the L o r d M a y o r T r e l o a r Cripples' H o s p i t a l and College at Alton, H u n t s , from Monday, J u l y 29, to S a t u r d a y , A u g u s t 3, inclusive. N o fee will be charged, and lunch and tea will be provided. F u l l particulars m a y be obtained on application beirgg m a d e to Dr. H . J. G a u v a i n , the M e d i c a l S u p e r i n t e n d e n t . 1 Copies of the Eleventh Annum Report of King Edward VII. Sanatorium Midhurst. dealing with the period July, I916, to July, I917. can be obtained on application to the Medical Superintendent+ Price is. post free. The Twenty-First Annual Report of the Loomis Sanatorium for the Treatment of Tuberculosis, at Liberty, Sulli, an County, New York, is published at the Sanatorium, and copies may be obtained on application. a The Fourteenth Annual Report of the Boston Association for the Relief and Control%f Tuberculosis is published at the Central Offices 3, Joy Street , Boston. Mass., U.S.A. 4 The Headquarters of the American National Association for the Stud~y and ]~revention of Tuberculosis have for some time been situated at the United Charities Building, lO5, East 22nd Street. New York. In future the Headquarters of the American Natic,nal Tuberculosis As.-ociation will be at 38, Fourth Avenue. New York City, UJS~A.