Welsh Newspapers
Search 15 million Welsh newspaper articles
5 articles on this Page
- West Wales Sanatorium.
West Wales Sanatorium. ANNUAL OF SUBSCRIBERS. alltymyx.dd"bijilding may BE OPENED AT EASTER TIME. The annual general meeting of the mem- bers of the West Wales branch of the National Society for the Prevention of Con- sumption and other forms of tuberculosis, was held at the Guildhall Cairmairthen, on Friday afternoon, when the President (Earl Cawdor, lord-lieutenant of Pemabrokechire), occupied the chair. There was a large attend- ance, including Sir James Willra-im-Diuvm- monel, Bart. (lord-lieutenant of Carmarthen- 11 1 1 -vaii-i shire). Edwinsford; Col. H. Davies-Evam (lord-lieutenant or Cardiganshire) Tighmead; General Sir James Hills-Johnes, V.C., G.CB, Dolaucothi; Sir Owen Seoufireld, Bart., Williamstown Col W. Lewes, Llysnewydd; Mr Mei vyn Peel, Da nyr allt; Mr and Mrs Dudley Williams-Drummond, Carmarthen; Mr aind Mirs Bertie Davios-Evanfi, Bwlch- bychain; Mr Meuric Lloyd, Dolfryn Mr Charies oyd, Waunifor Mrs W. J. Wil- liams, Picton, terrace, Carmarthen; Mrs Gwynne-H11 gbes, Glaiicothi; Mrs J. W. Gwynne-Hughes, Tregeyb; Dr H. J. Law- rence, Naiilborth Mr and -Mrs Trubshaw, Llanelly Mrs NoviM. Lla-nelly; Mr E. Milner Jones (Recorder of Carmarthen); Col. D. Morris, Ammanford; i-Aii- W. N. Joiii,es, Tiry- dail; Rev A. Fuller Mills,^Carmarthen.; Rev and Mrs iD. Evans, Llangunnor; the Miese* E. Falkeneir, Llangunnor; B. Falkoner Miss A. Mabel Davies, Frood-'Pfile; Mr E. A. Lewis, Saundersf oot; Mr (Iud Mrs R. M. Thomas, Landclowror Miss G. Thomas, Llarnddowror; Mr G. W. P. Brewer, iNarberth; Mr P. J. Wheldon, Carmarthen (treasurer); Rev D. H. Davies; 'Dr Hugh Walker, Lampeter; Mrs Herbert Mitchell, Bryniteifi; Dr Arthur Hughes, Ammanford; Mr Morgan Griffiths, Liime Grove; Mr Walter Spurrell, Carmar- then Mr T. E. Brigstocke, Car.mairhten; Mrs H. Colby, Aberystwith; Mr Wm. Thomas, Ll&ndelbie; Dr v. A. Brigstocke, Haverford- west; Mr E. Thomas, Llanybyther; Mr M. Williams, Llanylbj-ther; Frances C. B. Lloyd, Waunifoir; E. M. Stewart, Llandys- sul; F. M. Lewis, Felinfach Miss Mil ward, Tenby; F. F. Reecl, Tenby; Miss Ditcham, Carmarthen Mrs and Miss Wheldon, Car- marthen Mr C. Haydn. Williams, Carmar- then; Mr H. J. Allen, Tenby; Dr E. C. Thomas, Llanybyther; Rev D. Williams, Llanenog Principal Roberts, Aberystwith Dr R. A. Reed, Tenfby; and Dr Bowen Jones, Carmarthen. Letters of reoret at absence were received from Mr Morgan Richardson, Morgenau (in- cluding cheque lor tIO); Lady Scourfield, Mr C. W. R. Stokes, Tenby Mr Seymour Allen, and Mr Mitchell. Professor Aiiii-yi, Aber- ystwith, wrote hoping the committee would taiken into consideration especially the edu- cational effect the sa, iatori,iim-ii-oiil;d have on the people of West Wales. Whatever might be done, that aspect must not be overlooked. Extra care should be taken, by competent persons in the selection of cases for admission into the sanatorium, that impossible, cases should not be admitted to the exclusion of cases of posSliible cure. It was of paramount importance that the internal control of the institution should be in the hands of a thoroughly (pompdtent medical superinten- dent. The annual report of the ,executive was rea.d by the Secretary (Dr LI. Bowen Jones), in which the history of the Sanatorium was traced from its origin, and acknowledgment made of iSir James Drummnd's kindness in advancing a loan of £ 1,000 .and 1}1r David Davies' (Llandinam Hall) contribution of £500. A high tribute was also paid to the brilliant service rendered by the late Lady Drummond, as well as to the late Colonel Mayhew and Mr Daniel Stephens1 ,Arlais. The (report was received, on the motion of Mr Trubshaw, seconded by Col. Morris. FINANCIAL STATEMENT. Mr P. J. Wheldon, the treasurer presented the financial statement. On. the building account they had a balance at the bank on December 31st, 1906, JE430 16s. They re- ceived a loan of £1,000 from Sir James W. Drummond. Subscriptions came to zt232 15s lid; proceeds from a jumble sale "at Llan- gadock, 10s; Talley bazaar, organised bv the late Lady Drummond, £ 214 2s 3d; sale of garden 'plants, per Miss Davies, ^Froodvale, £ 2; Laughanne bazaar, C23; £6 100 from Tenby; fete 'at Llandilo, per Mrs Gil-rilgle- Hughes and Committee, £ 293 Os 9d; church and chapel collections, £ 120 6s lid district collection, £64 4s 10d; donation from Llatn- dillo, an District. Licensed Victuallers' Asso- ciation, £ 20; from Llandebie, £ 3; bank interest, £ 15 10s 7d. The total receipts for the year amounted to £2,492 Or, lid. Oai the counte rside they paid the architect C50 and the builder £ 1,5.0. The printing bill came to £8 7s 8d, and they paid fo rcopies of a pamphlet. on tuberculosis, £2 13s. The expenses at Alltymynydd, in road making, laying out the grounds, alterations to the building, came to £44 Is; sundry bills came to E38 10s, and petty cash to t 17 12s Gd. After making all payments thev had a. balance in hand of f:830 16s lid, hut thev had to rememlber that Sir James Drummond •had lent them £ 1,000, free of interest. In 1905 when he was elected treasurer, the monies handed over to him amounted to t3,465 17s 9d. He received en subscriptions £ 428 4s 6d, and from the Fancy Fair at Car- marthen t946 9s. He had from Mr Mitchell £.50, and the (purses presented to Princess Christian at Alltymynydd totalled R680 14s. Church and chapel collections came. to £ 206 17s 9d; district collection, zC64 43 10s; Welsh Football Union per Mr Mitchell, £ 50inte- rest on money, tl62 9s Id. On t,b, other 'hand they had paid out to the contractor, £ 6,500; to Mr Collier, the architect, tl75 5s; for plans, as; preliminary printing ex- penses, C28 lis 9d; general pi Anting and stationery, £ 24 14s. 10; and altogether the total payments came to £6,852 Is lOd There .remained due to the builder, f:145 17s and to the architect £90 15s, whilst, of course £1,000 was due to Sir James Drummond. A deficit of £ 405 15s Id was shown on the general account of the sanatorium, but it might be proper to add here, said Mr Whel- don, that the building committee found that them was work yet to be done without whilch the sanatorium would not be in a fit state to bieopetlwd, which would involve an expendi- ditu.re of £149. It was interesting to note the amount they had received from collec- tions in churches and chapels, on the whole he thought the response had been very good, butt he 'believed it was nothing to what might be expected if the matter was represented to them in the proper'way. From the Church .of England they had £100 10s 9d, and from the chapels £ 1(5] 2s., and that was a very creditable sum indeed to receive. Whatever pressure had been put on. th churches and chapels it was very disappointing to find that that ini Pembrokeshire and Cardiganshire the effort had been so disappointing, wbDut £ 19s 9s from Pembrokeshire and JEG Is lid from Cardiganshire. With regard to the dis- trict collection—m Carmarthenshire they atrefully divided the conuty into districts, and made a systematic house-to-house collec- tiom, tiherelby bring,iin,g in, zC64 4s lOd, but Car- diganshire and Pembrokeshire had done nothing. Dr Reid had paid in some subscrip- tions whlich were restricted to certain objects. Last year the deficit was £1,394 8s 4d, so that their deficit of R405 15s Id was a com- paratively low one. However, h- was pleased to inform them that by the good efforts of Mrs Davies-Evans that adverse balance would be, entirely wiped off, and they could declare to the public that the funds of the sanatorium were on the right sIde (applause) He had received a cheque of 20 guineas from Mr T. Lewis, Brynglas, he being desirous of .'becoming a life governor. He had also re- ceived a telegram from Mr Chive: .s in which he stated lie would contribute JE5. Mr Ben Evans, Llanfair Grange, had qualified for a life governor. On the motion o,f Mr R. M. Thomas, seconded by the treiv A. Fuller Mills, the accounts were referred to the finance com- mittee for audit and publication. Mr Wheldon said on, the maintenance account they had a }>alamice of £ 238 3s 2d, and interest allowed amounted to £ 9 2s 5d,' mating a total of E245 5s 7d; out of that they had paid the reiit of the sanatorium, ■the caretaker, etc., leaving a balaince of t93 8s 2d. The Pemlbroke Dockyard men had Fent a sum, ear-marked for maintenance, of R147 18s 9d, which, with interest, represen- ted a Gitm of tl50 lis 7d. Then, other monies for special purposes included a sum of tl33 6s 3d, the proceeds -of the, excellent sale at St. Clears. On the furnishing account they received from Mr D. Davies, Llandinam Hall £ 500 which bore interest at tll 7s lid. They paid for special flooring CI56 11s 5d, which left a balance .n hand of JE354 16s Gcl. Since then he had received from Mrs Trubshaw a cheque of £ 294 9 s, which, added to the balance, would adequately cover any expen- ses they miight be called upon to pay for furnishing. He had received from Mrs Davics-Evans, £ 155 5s, which stood in the suspended account. Dr Reid siaid that lie had in deposit in the bank in his name, £68 3s, and his son, Capt. Roiel had, by promoting an entertainment, been able to make tloj 8s lid. Those two sums were deposited at Have; ford west, making interest. Out of those sums t60 odd had .been sent to the treasurer, and the remainder would be paid over when the sana- torium was opened. The accounts were then referrul to the finance committee for audit and publication. COST OF MAINTENANCE. The Chairman, who was received with applause, said that he had a 3ho11. statement to make of what he had tried to do with regard to the rules. He quite appreciated the difficulty of draiwing up rules. It was not an easy thing to do, bti,L. most of them would agree that the rules as they stood in print did not work out quite as they wished, and he had taiken- upon himself the invidious task of 'amending them. He hoped Air R. M. Thomas would assist Mm in amending his own rules. He thought they ought to make It quite clear what every subscriber was going to get for his money, and they ought to put that iin such a form that they could put on the Ibaek of a ticket, or whatever he got for his .subscription. That would be the means of drawing in considerable subscrip- tions. He suggested that an annual sub- scription of £1 would entitle a person to become a governor. He thought that would work out very well, and that further the sum of £1 in subscription would mean one letter of recommendation, for the admission of a patient. Twenty letters of recommendation would mean. £20, wnich would cover the maintenance of a patient for three months. Forty letters of recommendation, or JE40 would maintain a patient for six months, and 75 letters of ire'commendatino, or £ 75, would maintain the patient for the whole of the twelve months. He did not himself care whether the tl wa.3 found by one individual or an association, of persons. As long as the money was raised, they woul be entitled to the letters of recommendation. That would be a useful thing which coul dbe easily ex- plained. The governor might be the repre- sentative of a number of people selected by themselves. Any corporation, any local authority, any association of persons, or any ndividual would be atbie to subscribe for as many letters of recomimendatioai they re- quired, but no matter where it came from every zEl would have its own and the same value. If an individual or association of persons subscribed a large sum they should be entitled to nominate a member for the executive committee. Thn he thought they should have some limitation to the executive committee, 'but he, would not press that the nun-liber should be ten. He was in favour of a larger number, and would suggest seven for each, county, which would give them 21 members He must confess that the sugges- tioHs were .not his own making, but he had been studying the ruiles of various sanatoria, and had taken isome suggestions from those of the Devon and Cornwall Sanatorium, which was 'doing very good work. If they got a rock-bed of J61 they did not want anything more. Any authority could give £75, and they got their bed for one year. Patients would be admitted on lotteri of reoemmenda- tion, and seven such letters would* entitle a person to one month's treatment, and twenty letters to three months, and so on. He thought they might find it useful to put in the 'rules that for every week, or fractional part of a week, over the time a patient was admitted for, a charge of E2 'would he made. His object was, mow that they bad airived at the parting of the ways, that they should fill the sanatorium as soon as possible, and, therefore, they would have to put their house in order so that it would work as smoothly and simply as pos.sib1.e,ailld let every contri- butor know what he was going to get for his sujbsoniptLon. He felt very strongly indeed that they were very much .indebted to those who were doing and bearing the Ibrunt of the work of that sanatorium. He was afraid he had not done anything himself, biit he had watched all that the others had done, and they owed a deibt of gratitude -to those ladies ar;d gentlemen. But he was thin/king now mor:- particularly of their officers. First of all thiey must tender their tliafuks to the hon. secretaries (applause). They had done ad- miraoiio work for them, and he hoped it was some satisfaction to them to see their good work coming to fruiition. # Also, they must thank their treasurer for all the work he had dome (appilause), but he could not go through all the ladies and gentlemen, but those who had done good work knew it quite well without his telling them, and bi'iinging blushes to their faces. Those of them, who, Lb himself, had not done much yet, should make up their minds to give what help they could. The lines on which they should now work ought to be somewhat changed. He thought the time had come when they should haiVe one secretary instead of four, as at pre- sent, and, of course, the executive committee would give him what paid assistance he wanted in the way of clerkage. He did not ■want the ^hon. sees, to feel that they uiwler- yailued the good work they had done in pilot- ing the ship so far. He and they also appre- ciated the splendid work done by the trea- surer, but he thought as a matter of pure, simple business, they ought to arrtange their position in this way. He did nob think the treasurer should 'be the bank, and he, did not think the banker should !be the treasurer and lie did not think the treasurer should be on the finance committee, because the com- mittee was told off to look iafter the trea- surer, and the treasurer to look after the bankers. He thought they should try and separate those offices retaining in o-ne capa- city Air Wheldom, whom he 11 ,hoped. would still continue to give them the benefit of his great assistance. The separation of the offices was quite usual, and really the right thing to do. •Mr Wheldon asked whether the £ï5 would be sufficient to cover the cost of maiiiteni- ance. The Chairman said Wat lie had looked at a good meny of the working sanatoria, and found that they worked very satisfactory on £ï5. Dr Bowen Jones said that he thought it was sufficient. Dr Reid said that the offer to the County Councils was to give them a bed ror JE65 a year, an that offer still stood good. He thought it was too liberal an offer. Until the sanlatorium got into full swing it would cost more than, 1:65 to maintain a bed. He thought £i5 was as near the mark as could be. IDr Bowen-J ones said that he would rather call it £80. It depended on what they paid their resident medical officer. The Chairman said that foir three and six months the charge was jE80, and people who took a bed for twelve months got it £ 5 cheaper, and so he did not see- much in that. Rev F. Mills suggested that the charge should be £65. He knew the difficulties they had to contend with in the past, but they wanted to ipopularis/e that institution as imuch as they cotild, aiiid iii view of the County Council inquiry, if they could see their way clear to say zC65 it was more likely to Ibe aecepted than £ 75. The Chairman: Ron would not say more likely to pay (laughter). R,ev F. Mills: We are prospepting now, and the maintenance of the institution will liave to comie :"1> later, on. If they created a ™ lc'e. aSa'n,'jt the institution in the V }1 'fll ou'!d become a dead letter. ;;r^eldo11 f^id that it must be borne in i f. ( ] won;ld have to iplovi-de shelters aind toooL foi the patients to work with, because uork now was an integral part of the treatment Ihey would have a difficulty in finding sufficient patients m the initial staap to fill the iiistitutioaii. The Chairman said that he thought he mnst hang on to his t75. Mr Wheldon, There will he no difficulty in lowering it. Sir James 'Drumanond: Are we going to decide to-day when, we shall start the sana- torium ? The Chairman: AVe must leave that to the executive committeei. i-Itr Brewer agreed that offices of treasurer and banker should In separated, but with re- gal d to his friend, Mr AVhelelcn, he was the treasurer, and the hankers were the banker, and they were two different people. Whether that was sufficint to- creat the independency to which his lordship referred, he did not know. There was, the- fact that ,}11- Wheldcai was not the íbanlk (laughter). Mr Wholdoni: I wish I was (reupwed laugh
Advertising
-J- "T "DTTT TXTVir VATT" 1 BJCiljlJliVHi lull 0 I The word of a Carmarthen won.an has I more weight here in Carmarthen than the word of a stranger. Because the formtr can b, easily proveii, and the latter cannot. Tli, refora wo give hero the statement of a Carmarthen wonKin. Doan's Backache Kidney Pills act only on tho kidneys and bladder-help them to filler the blood-to take out the uric acid and impurities that cause the nching back cure dropsy, heart trouble, bearing down pains, headaches, nervousness, sleeplessness, etc. A book will be sent free. A CARMARTHEN I WOMAN. Six years ago Down's backache kidney p:lls (Jured me of kidney disorders, and I huv-j not been troubled in that way feince," says Mrs C. Ray. 1. Friar s- entiance, Mill street, Carmarthen. My cure has proved a lasting one." llero are the particulars of Mrs Ray' cure, w bich she gave us som* years ago My neighbours have said how much better I look since using Poan a back- ache kidney pills, and I can honestly say that the medicine h,is done me a lot of good. I was troubled with kidney -oiiiplaint for y"ar¡: and ry-V uack was so bad that 1 oald scarcely titand up. There were also urinary diso ders. After taking a ftw doses oc Doan's backiche kidney pills I felt easier, and now 1 am quite well again. I have lo«L the pain in my back, and the kidneys are acting freely and raturally. (Signed) Charlotte Ray." Yon can obtain them from any ohemist or stores, or post free direct from Foster-McOlellan Co., 8, Wells- street, Oxford-street, London, W. 2s. 9d. per box, 6 boxes 13* i'd. So as to avoid all chance of mistake, ask distinctly for DOAN'S. clip-, .> s CKACHE KIDNEY PIJLS
Official Report on Sanatoria.
Official Report on Sanatoria. The "Times" of Friday last contains a lengthy review—evidently written by an ex- pert—of the official report On Sanatoria for Consumption and certain other aspects of the Tuberculosis Question." The work was ordered to be produced by Mr Long, when he was President of the Local Government Board, and the work of producing it was committed to Dr. Timlbrell Bulstrode, one of the Medical Inspectors of the Board, who has visited every public sanatorium in England and Wales in order to gather information on the subject. Whilst not unfavourable to sanatoria, the report certainly seems to take a lower view of their utility than is put forth i,J1. the statements of the supporters of those institutions. As to the curability of consumption, the report points out (we quote the "Times"— 'CQMMUNCABILITY. In the third chapter is discussed the im- portant and much-debated question of the degree of co mrou mi cab i 1 i ty of consumption from person to person; and Dr Bulstrode shows in how marked a manner, in this respect, the disease differs from such mani- festy infectious maadies as^^yphus fever and small pox, or even from the more mildly communicable enteric fever. In his view the best test of the actual communicability of any disease is furnished by the proportion iin which those engaged in nursing or attending upon it are attacked; assuming, of course, 11 that they are not protected, either by a previous attack or by some form of preven- tive inoculation. Ln this country, at any rate, the attendants upon the tuberculous sick seldom fall victims to the disease; and this is the more remarkable, inasmuch as the data relative to their immunity partly relate to periods antecedent ot the discovery of the bacilus, and when no steps were taken to prevent infection either by dust or by drop- lets. It may be urged that there is need for more accurate records concerning those attendants than we now possess, more parti- cularly as to the precise condition of their lungs at the times of entering and of leaving the service; but, be this as it may, there is a. unanimity of opinion that the incidence of tuberculosis upon those who attend the tuberculous sick in hospitals or sanatoria is insignificant when compared with the inci- dence of typhus fever or smaM pox upon those who nurse patients suffering from either. The difference is so remarkable that, as Dr Bulstrode points out, pulmonary tuberculosis might, on this evidence alone, be thought to merit a class to itself. He shows, moreover, that communicability, as measured by inci- dence lupon, healthy men and women married to tuberculous persons, has not so far furn- ished any very decisive dtaa. Whitelegge and Newman, in their text-book on Public Health, observe that 'statistics are incon- clusive even with regard to the transmission of phthisis between husban and wife.' On the other hand, data have been accu- mulating during recent years in which evi- dence of the association of consumptives with other consumptive workpeople or rela- tives has been forthcoming It ;s, neverthe- less often difficult correctly to appraise the value of this evidence, inasmuch as it is never easy to determine the date of the actual onigin of tihe disease. Dr Bulstrode quotes Portal to the elect that, in estimating the starting-point of consumption, we have often to refer 'back to early symptoms being forgotten, t oa hemorrhage in youth or to an attack of feverishness years before. He also calls attention to the evidence which indi- cates the widespread prevalence of tuber- culosis among mankind, and which proves that a very large proportion of the poorer classes among tihe adult population are, or have been, invaded by tubereule bacilHi, often in unrecognised and hence untreated forms. The records of post mortem examinations, on persons who have died from other diseases tr trom accidents, conducted both in this and i notlier countries, seem to suggest that old tuberculous lesions are constantly de- tected when carefully looked for. The facts thus ascertained, while tfhey establish the wide dibusion of tuberculosis an dthc multi- ple risks which all must run of being infected, are also of good augury, in that they indicate the .frequent curability of the disease even by the natural powers of resistance. They also indicate the probability that,, when, a case of tuberculosis occurs in a working household, the other members of the family may have their powers of resistance lowered, and may be rendered more prone than before either to the occurrence of a new or to the awakeniin'g of an old infection. These con- siderations have not been overlooked by th.-ise who live brought together facts .illustrative of real or supposed coWftnunicabiliitv; and it is clear that tihe evidence under this head must be weighed in connexio.n with all that points in a different direction. I tis ob- viously not improbable that frequent or pro- longed exposure to infection under condi- tions of overcrowding, dirt, defective iÍg-ht and ventilation, underfeeding, and the like, would often entail considerable danger; and it is at least not unreasonable, as Dr Hul- strode suggests, to consider pulmonary tuber- culosis as a "conditionally infectious" or "su!b-infect,iou" disease. It is nevertheless impossible to determine the precise import- an which should be attached to direct in- fection, so long as the amount of tuberculosis due to the drinking of tuberculous milk re- mains undecided. It vs clear that, so far as liability to Ültfection bears relatioai to the dosage or number of bacilli taken into the system, the disease is more likely to be acquired from milk that from dust-borne bacilli..Moreover, the problem recently stated by Von Behring and others, with re- gard to latency, still further complicates the question of infection betwen case and case in adult life. There is an increasing bodv of evidence to support the belief that unsus- pected tubercular ilesions are latent in vast numbers of people, in some of whom, at least, they are capable of (being roused into mis- ebevions activity. Von Behring quotes sta- tistics from Rancy, a medical officer in the Austrian Army, who tested the men of two regiments with tuberculin. In the men of the first year of service he found 61 per cent, and of those in the second year 68 per cent.' to be infected with tuberculosis. Professor Sir Clifford Allbutt, in a recent address" said, I am guilty of no extravagance when I suggest that one-third of you who hear me, wittlilngly or unwittingly, are, or have been, infected with tubercle.' VALUE OF SANATORIA. Proceeding to the consideration of the value Of the sanatorium treatment of pul- monary tuberculosis, Dr Bulstrode points out that at this early stage of the progress of the moveme in this country, it is both undesiraiblle and impossible to draw precise conclusions from the evidence so far avail- able. Many of the institutions have only recently been opened, and all have had to pass through somewhat trying periods of their history. They have had to withstand disappointment caused foy the no'n-roR]iza- tiom of the too sanguine statements which heralded their advent—statements to the effect that a very large percentage of all cases admitted illlto them would be "cured," and that by a general provision of sanatoria tuberculosis could be "stamped out." No competent epidemiologist ever made himself responsible for these or similar statements. So, too, il any endeavour to estimate tho value of sanatorium treatment, the method of selection of paticrt; must be carefully kc,),t tu. view. It is obviously misleading to co-inpai-t- the results of an institution Jairgely filled with cases taken direct from some Poor Law establishment with those of another which admits only persons who have already manifested a favourable reaction to rest, food, and a disciplined life in some hospital. Moreover, no reasonable comparison can be instituted ibetweeii, a sanatorium filled with cases in which the tuberculosis is "open," and the sputa arc crowded with bacilli, and one which selects cases in a pre-bacilliary stage, or, conceivably, by means of blood- examinations of the patients. It is ther-efore lieees&ary, in examining the figures relating to sanatoria, to have regard to the method of adol),ted in each. There is, also, much iic-ed for the adoption of some uniform system of nomenclature and classification with regard to- the states of the patients both on admission and discharge. The multi- tudinous terms inow used are so vague and uncertain as to render comparisons between diffr,ent institutions almost valueless. AFTER RESULTS OF TREATMENT. In examining the tables relative to after- results it is of (great importance to bear in mind the method of selecting cases in force at each siii-toritim, as otherwise injustice would be done to those by which advanced cases are received. The figures of the differ- ent institutions are given in the report with the greatest attainable completeness, and occupy nearly 300 pages, iijsomuch that it is impossible here to deal with them collectively while it might appear invidious to select particular institutions for comment. As a rule, we hear that the results will be con- sidered disappointing, especially when looked at in the light of the amount of permanent improvement recorded. As two examples, we may take the Hull and East Riding and the Durham sanatoria. From the former (p. 549) in (the years 1902-5, 183 patients were discharged, of whom 43 were admitted in an "early," 98 in, a "moderately ad- vanced and 42 in an "advanced" stage of the disease. They were all discharged by the end of 1905, and on the 31st of December, 1906, it was ascertained that 32, or 12.6 per cent., had maintained their improvement, 5 were "worse," 103 were "dead," and 52, of the majortv of whom it was believed that they were also dead, were returned as "un- accounted for." At Durham, during the seven years 1900-7 (p. 376), 406 "early or consolidation cases" returned to work, and of these, on the 30th April, 1907, out of the 303 who had "returned to work," 197 were still "at work," 47 were "at home," 92 were "dead," and 70 were "lost sight of." During the same period 268 "advanced or cavity eases" returned to work, and of these, on the 30lh of April, 1907, 41 were still "at Work," 34 were "at home," 141 were "dead," and 49 had beeen "lost eight of." SANATORIA AND THE DEATH RATE. Among other expectations held out by the early promoters of sanatoria it was main- tained that they would tend to diminish the general mortality from consumption, alike by then- direct effects as life-saving institu- tions, and by therr educat onal influence in promoting better domestic lighting and ventilation and better care against the diffu- sion of infective material. It ciiiino-i be said that any evidence exists to show that thece expectations have been realised. In Chapter XXI. Dr Bulstrod e giver, charts of the death-rates from consumption in certain counties with and in others without sania- toria and it is obvious that the latter class rf data will be useful as indications of what may be expected from the disease in the absence of any measures specifically directed agaimst it. If 'better results, in so far as the permanent arrest of the disease is con- cenred, are to be secured by sanatoria, it is clear, as is 'brought out in many parts of the report, that fbe-ttcr machinery must be dcrrsed for attracting cases at earlier stages of the malady. There is very great difficulty in securing such cases, and, in spite of all efforts in this direction, it cannot bo said that substantial progress is being made. The importance of early 'recognition and treat- ment is not fully or even adequately recog- nised: and experience shows that the work- ing classes, under existing conditions, will not relinqui-h work, and leave their families to charity or to the Poor Law, unless they are compelled to do so, or unless some arrangements satisfactory to themselves can be made for ihe support of those dependent ■upon them. Thry prefer eithe-r to seek no medical advice at all, or to attend as out- patients at some hospital or dispensary. The state of things in this country presents, in thirespect, a painful contrast to that exist- in Germany, where a law of compulsory insur ance compelt? the working classes to make provision against sickness, and where the national character of this provision at once secures it against abuse and renders it fully effective for the purposes which it is designed to promote. The "Times concludes a leading article on Saturday as follows:- "On the whole, the latest conclusions upon the subject appear to be that tuberculous milk and meat, more especially milk, may possibly. after all, bo the chief source of danger to mankind that infectoii received from food may find its way to the lungs, as ""ell as to the hone-, the joints, and other other portions of the body which are liable to homo place, of lodgment for the bacilli, and that the deposits so formed, whether in the lungs or olsewehere, may either lapse into a passive state, for long periods or per- manently, or may be roused into activity by external ciro imstances adverse to health. Tli,- sanitary problem, as thus presented, di ffers greatly from the- form which it ori<rm- ally assumed; and the methods which it should bo dealt with must, of course, differ in a corresponding degree. It would appear, from this aspect of the genera! question, that the establishment of sarato'ia for the reception of declared cases of consumption, in which the patients n1ln-v 1)0 taught how to live, and how to avoid thr> d;s cminiatxm< of infective material, Avas a proceeding whr.~h, however admirable as a benevolent provisio.n for suffering individuals was bardlv likely to fulfil, the expectations which it had at first occasioned in many quarters, although these expectations, as Dr. Bulstrode carefully points out, were not en- couraged by instructed pathologist*. It has not been found, so far, that the existence of these sanatoria the lrstorv of which has been followed i,n deail by Dr Bulstrode for seven years, has produced any perceptible effect upon the rate of deeline of consumption mor- tality, either in, England and Wales generally or m the counties possessing such institutions a: compared with those which are destitute of them; and tliei rown records, when care- fully examined, seem to indicate that, in the case of a very large proportion of the patients received, they have done little more than postpone the fatal issue. As regards the curative value of sanatoria therefore, even- at an early stage of consump- t on, more precise data are greatly to be the'Trelt Ut *° b° "° floubt that the treatment, ,.n, such an early stage, has, t,m°r *r°n exceedingly bene- he al ^hat the actual extent of this benefit may be, in respect either of amount or of show8 htTfi, is required to Slrow but the general character of the report appears to lead to the conclusion that The treatment of the lung affection can at best form only a part of the means which should be employed in any national endeavour to arrest the ravages of tuoor- culosis generally The opinjolll ar; to the com- parative harmlossness to mankind of the hovi ne bacdb expressed a few rears ago by Professor Koch, has not iu gx r further i i stood the test of plain from -] f H^ndent inquiry; and it is Commission "T" of +ho ,,nfU meat an<1 milk supplies sun'n-i^ln i'i L nrft"r>ntl.v for more careful V+"l v k T hitherto beo.n extended t.. ,ep' 11 a rePort, just published by the Local Government Board, on the sanitary state of the rural district of Dorchester there is a description of dairies which SPllld largo quantities of milk to London ■which are conducted in a manner nnt' n msanotary, but disgustingly unelem a"7 long as such proceedings are p L + £ s extension cr tuberculosis from k the to milk consumers can hirdlv ,i°Vmc am™als and, indeed, is fa! J vmtd; increased." likely to be
Advertising
Jbe Great Skin rnre. Will care f after one application desfcrom orm of Ec-zenift bPal Old'wo, nd. wdSoEi • S 'ike a c arm on Leers; is infallible^for Pi £ f. will cure Rin^o™ in a few ays rpmovrs the most ohat.irate FmnflJ,. *rd Senrvy. R->vP,t 7W. and Js. lJ. Agent fer Onvrn>uthen, Walter Liovn Kidw.Uy, I,. 1W, Whitl„d H i Wil^! Chemist; Narberth, A. W. Tooht ni Clynderwen, H. Morbis, Cfcenjst.
- West Wales Sanatorium.
ter). It had been .my intention to lay down, very respectfully, the treasurership. Con- tinning, the said that the office was no sine- cure, and the srreat difficulty he had had Was that he could not get all the money together. Sonne of the money was in the bank at Pem- broke and Haverfordwest, and 'elsewhere. He was delighted to see his lordship in the chair ifor the first time at their meetings, because they would get the benefit of his wisdom to put them on proper business- lines, and he thought it ought to be laid down that day that all money was to be handed over to the treasurer, and a.M correspondence to the secretary. He was proud he had put in three years hard labour for the sanatorium, and to have followed the splendid leadership of Lady Drummond. But for her he did not think he would have 'been, willi the object, but coming in contact with her, and seeing the thoroughness of her work, convinced him of the efficiency and efficacy of the sana- torium. Mr Trubshaw thought they would 'have to alter their rules from time to time to suit their particular requirements. Mr Wheldon saild that the whole gist of the sanatorium was the admittance of proper patients. He did nQL thinilf they should allow rich outside patients to come in and take up all the beds to the exclusion of their own poor patients from whom subscriptions would bo made. The Chairman said they were governed on that point by the existing rules which pro- vided that no patient should be admitted unless there was a prospect of cure or allevi- ation, and that no patient should be ad- mitted unless tke committee, were satisfied that the patient coul not pay for his own maintenance in a private institution. They wouid have to have some form or certificate to be signed tby a magistrate, or minister, or other reepansilble person to state that the patient had no means. Rev A. F. Mills sa.id that he was anxious to bring the institution, into close {ouch with public bodies such as Boards of Guardians and County Councils. Mr Trulbshaw said that they would have the £1 basis. The Chairman Public bodies will be in exactly the same position as anybody else. Mr W. N. Jones sai dthat if the district f ouind the money they^would be able, to nom- inate a person or persons., but the medical officer of the restitution would be 4allowed to veto the patient subject to the rules of the branch. The subscribers would not be able to insist om, a patient going in if the medical staff thought the patient could not be cured. Chairman Certainly not. You are gov- erned by your rules. Principal Roberts said that it was a matter of great satisfaction that their object had been brought to a successful conclusion as far as the building was contcerned, and the indebtedness of all interested was very great to those who had worked with such devotion for the attainimig of 'atresu'lt. They had now come to the second stage in connection with that task, and in listening to what had been said by Mr Wheldon and others with referencei to the proposals before them it appeared to him that they could not devote too much time and attention to the con- sideration of the regulations which were to guide the admission of patients to the sana- torium. The question which seemed to him to be of the utmost importance, was whether in the proposed system there would be free and full opportunity for patients, who were in every respect urgent cases for admission, to Ibe considered by the committee. Did the proposal submitted to them involve the pro- bability that the admission would be too much controlled by the financial considera- tion? Was it not possible, now that they had the question of maintenance before them that a sufficleiit sum for the maintenance Off the sanatorium could not be provided which would n4ot limit the Seleeti-oll of patients to those who had been fortunate enough to secure the necessary amount of letters of recommendation1. He felt that if that could be secured it- would be of very great import- ance, especially to the more rural districts within the three counties. Would it be possible ibefore, the rules were finally adopted for them to be considered by the executive or any other committee, and to be submitted to a final meeting of the subscrbieirs to be held after a sufficient interval of time. The Chairman said that they had been printed 'and circulated amongst the members for some time. Principal Roberts said that in looking at those proposals he was bound to say that si,nee—especially sin the passing of the Administrative Provisons Act, of 1907—the question, of organic relation between such an institution, as that and the County Councils was hecotming more and more important, and anything j'lll the scheme—he was not saying there was no prospect, hut he was afraid there was not much prospect of that institu- tion heinK placed under the control of the County Council.—■ ut 'anything that would tend to bring the institution into as close relationship as possible with those authorities which Avill have the superintending of the heal,th of the district very largely in their hands, would he -of pulblic advantage. The Chairman sincertlv hoped that they would go on and do something and pass their rules. There did not seem to be much differ- I ence and he did hope .they would try and t'1 finish that day. With regard to shutting the door to County Councils andjither local uthorities they were doing the very reverse. They were adopting a rule which would make it possible for every local authority-—boards of guardians, county councils, and others, at any time to take as many beds as they re- quire on the zCl basis, and at the same time secure (representation 0111 the executive com- mittee. Instead of having a hard aaid fast "yes" or "no" they were giving these bodies the privilege of coming in whenever they pleased, on exactly the as me conditions as anybody else They could not throw the sanatorium open more fuily and freely than by adopting the suggestions they had aiade that day (hear). Mr R. M. Thomas said that if he did. not fa'll in with every suggested amendment it was not through any jealousy of authorship (laughter). He would like to point out that in the printing of the rules many printers' errors crept in altfi-ed the meaaiiang, and ill some oases made the reading neither sense nor grammar (laughter). <0> The Oha:nmaaii: I never attributed that to you I can assure you (renewed laughter). Mil- R. M. Thomas thought they should make it perfectly clear that patients ad- mitted .would be selected by the medical board. If it got out that R20 secured a bed far a patient for three months and then the subscribers sent a patient, who was refused by the medical board, they would get offen- ded an perhaps not subscribe a.ny more. The people ought to know that only patients thought suitable by the executive committee acting under the advice of the medical board would be admitted. The Chairman, thought thiat difficulty could be got oveir by putting a clause on the ibacik of the letter of recommendation, saying that patients were to be admitted under certain conditions. Mr R. M. Thomas said that he would much sooner leave. the power of the executive com- mittee as unfettered as possible, and let the rules grow as they went onf. He would prefer a relaxation of the rules so as to give the executive committee imore and .not less dis- cretion (hear, hear). After further discussion several alterations to the t u]es were agreed to. Tho Chairmaill's snggestions rega/ring the letters of recom- I men.dation were unanimously carried, and, on the motion of Col. H. Davies-Evans, it was decided thait the-xeclltive- committee should consist of 32 members, with the four trustees (the four Lord Lieutenants), as ex- officio members. It was agreed that the representatiooi on the executive committee should 'be as follows —Carmarthen,shire, 16 members Pembroke 8, and Cardiganshire, 8. I ELECTION OF PRESIDENT. Sir James Drummond proposed the re- election. of Earl Cawdor as president. He was sure they could not have a better one, and it was a groat pleasure to see him there present in the chair (applause). The mot:on was carried unanimously. Mr Wheldon said /that he would like the name of Mr David Davies. Llanditnam Hall, to be associated with the institution, and, oil the motion of s: James Drummond, Mr Davies was re-elected vice-president. ELECTION OF OFFICERS. Dr Reid tendered his (resignation as one of the hon. secretaries. He was appointed hon. secretary in December, 1901, and he was sanguine enough rto think then that the work would have been completed in six months, bnt it had taken six years to accomplish it. The conitimiance of four hon. secretaries with little 'or no comniumcati'cin between them, was useelss, but he was very grateful for all rthe assistance he had received. The President said that. he was stlro they were all very grateful to Dr Reid for the work he had done. Dr iBowen Jones said that had it not been for the gi--eat assistance, h, had received from Mr Wheldon he would have heen tmahle to attend to the secret-at-ial work as he had done The Chairmian, said tha Mr Wheldon, ho Was iswro felt that they i ll appreciated the great wtork he had done for the sanatorium b Mr Wheldon. said thu personally he thought they had better appoint another treasurer. He thought it vas ondv fair to say that the Baai-k had dealt very generously by the society, and had allowed a higher late of lintcnes't on t'ho money on deposit than he could possibly have got for any customer of his (applause. &;i" James Drumanond acknowledged t'he iravahMlbie work Mr Who; don had done for the society, and hoped he would stick to the ship .and see them through. It was decided to leave the election of treasurer to the executive committee. The Chairman thought rhat the Secretary in future should reside nHIJ." the sanatorium. He did not see how a secretary Hiving a long way off could work it. 13 Mr Trubshaw said that :¡ter on the resli- dent medical fficer would ie the secretary i inoti'°'in of AEr Sheldon, seconded by Mr Trusbhaw. Dr Bowen-Jones was elected secretary, and he consented to act in that capacity until the new regime came into force (applause). Really 'ohe work was too much for him, and meant his neglecting his own work. In the absence of Sir James Drummond, If Mr Dudley Drummond moved "That the West Wales Sanatorium at Alltymynydd, being now free from deht,and having suffi- cient funds 'iin ba-i-bd to furnish and equip it, this meeting is of opiinon that there is no further reason for delay in, preparing it for the reception of patients, and therefore desires the executive committee to take steps to obtain tenders for furnishing at as carlv a date as possible." Dr Reid seconded, and the motion was carried. Col. Davies-Evans moved "That it be an instruction, to. the executive committee that they shall at an early date consider: 1, The necessary staff for the sanatorium: 2, That steps tbe taken for the selection of such offi- ccrs and ,attendants as in their opinion will be required, in accordance with Rule 9 (b)." The motion was agreed to. .Mr Trubshaw was appointed convener of the meeting. A vote of thanks to the President con- cluded the meeting.