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CAMPAIGN AGAINST CONSUMPTION County Meeting Supports the National Memorial Scheme. Called by Sir Watkin Williams-Wynn, as Lord Lieutenant of Montgomeryshire, a "county public meeting" took place at one o'clock last Saturday afternoon in the Council Chamber of the Welshpool Town -Hall, to support the Welsh Anti-Tubercu- losis Campaign, which will be the national memorial to the late King. All the local speeches were marked by a businesslike, earnest desire that Montgomeryshire shall do its share handsomely in the campaign, which Mr David Davies, M.P., has com- menced. SIR WATKIN PUZZLED:. OUR BOUNDEN DUTY." Sir Watkin had a hearty reception in rising to open the meeting. The idea, he said, is to see how Wales from north to south can best unite in perpetuating the memory of our late Kng Edward VII. Even now there is a great barrier between North and South Wales. They look upon them- selves in many ways as different peoples. The south is almost entirely mineral—they gain most of their livelihood from the min- erals. North Wales is largely agricultural. But still we are all Wales, and we all want, if possible, to do honour to our late King with a memorial from the Welsh people generally (hear, hear, and applause). The only feasible suggestion made at the recent conference at Shrewsbury was that of Mr David Davies,-(applause)-one I my- self cordially agree with—that the best memorial would be, not a memorial in one particular district, not a statue to be put Up at Cardiff or Carnarvon, but something that would be really for the benefit of the Welsh people (hear, hear). And nothing commended itself more than to wage war on that terrible scourge, which is spreading throughout the whole country, that is tuber- culosis or consumption (hear, hear). Wales is one of the blackest spots in the United Kingdom for consumption,. Perhaps many of you, like myself, did not know that point, until it has been brought prom- inently before our notice now. Why it should be I don't quite know. But with all our hills and fresh air it seems curious that consumption should commit such ravages amongst us. But here we are. And there it is! And it's our bounden duty to do What we can for the good and health of the People generally (hear, hear). We hear a great deal of what we do for our souls. We build churches and chapels. We do a great deal with education in schools. But up to the present very little has been done for the health of the people generally. Possibly that is quite as im- portant a matter to look after as anything thing else (hear, hear). THE CASE OF THOUSANDS OF I COTTAGES. The following resolution was proposed by Mr Hugh Lewis:— That this meeting of inhabitants of the County of Montgomery heartily ap- prove of the proposal for a National Memorial to King Edward VII. (to pni- brace the whole of Wales and Mon- mouthshire) in the form of an anti- tuberculosis campaign, and hereby pledges itself to do everything in its power to further this movement, by the collection of funds within this county, and in carrying out the object aimed at." This great scheme, said Mr Lewis, may be truly called national. It will unite the 'Whole of Wales, Conservatve and Liberal, Church and chapel, rich and poor in com- memorating the life of a great King by bringing health and vitality to the nation (hear, hear, and applause). We are proud that it is due to a Montgomeryshire family that a scheme of this magnitude can be successfully carried out (hear, hear, and applause). We are proud of their princely hospitality, and proud that our County Member has thrown himself with such en- thusiasm and zeal into this great scheme (applause). The great thing is to bring home to the people of Wales that the dread disease of tubercufosis can be cured. But there are thousands of cottages in this beautiful country of ours amongst the hills and dales, in which the blessings of fresh air are not appreciated, and where very often the win- dows are not made to open. The task of bringing this home to the people is so great that it has made some people luke- warm. I have heard people say, It's- not a bit of good. People will have their own way!" But so much has been accom- plished that the task is not. hopeless. Deaths from consumption have fallen from 29 per 1,000 in 1878 to 16.5 in 1905 (applause). That shows what education and the spread- ing of the knowledge of the advantages of fresh air will do. We are spending a great deal in properly ventilating our school- rooms,—(Mr David Davies: Hear, hear)— and it is an object-lesson to the children and to future generations. Since German insurance laws have given legal claim during sickness to the poor, it has become pecuniarily profitable to start a vigorous campaign, which has been so successful that consumption is very quickly being wiped out in Germany. What has been accomplished in Germany, surely can be accomplished in Wales.—(Mr David Davies: Hear, hear). THE POOR THEMSELVES CANNOT DO IT." Although we are talked about in different places as sleepy Llanfyllin," said Mr J. Marshall Dugdale, seconding the resolution, we are not so behind the times now (laugh- ter and applause). There are 43 people col- lecting from house to house on behalf of this memorial (applause). I should like to have seen the extinction of cancer men- tioned in the same breath. I don't know in my own district whether consumption or cancer is the worst enemy. Going around, as I have dome canvassing, I have come to a place where there are a lot of children, and one consumptive .amongst them. That is the sort of thing we want to deal with—to get these consump- tive children away from the healthy chil- dren to some place where they will be looked after and well treated. The poor themselves cannot do it. Very offen the owners of the cottages cannot give enough accommodation for the number of children. At present the housing system is one of the most important things to consider. I am not going to enter into it to-day, because others are going to speak. Now we have three or four lots of people to provide cot- tages for. We have the young people when they marry-they don't want a big house. We have the widows—they don't want a big house. We have the old-age pensioners who are coming out of the workhouses- thank Heaven!—(applause, laughter, and smiles)—and going into cottages again they don't want a big cottage. The men with moderate families want helping. And there are those with large families. And these are the difficulties (loud laughter). Legislation, as at present, does not help them much., They have to help themselves, and very often there is over-crowding. Toj my mind what can be done is to help those people who own cottages to put on extra rooms, if they will undertake in writing that they will not raise the rent of those cottages (laughter and smiles). And if they raise the rent afterwards, that they will re- fund to the authorities or to the Govern- ment the sum that it cost to build this extra room. That is a practical suggestion I throw out. The Chairman at this stage announced a telegram from Lord Kenyon, regretting in- ability to fulfil his engagement to attend and speak. "He has taken a very active part in the same movement in Shropshire, and I am sure would have given us some useful advice."—(Mr David Davies: Hear, hear). CAN DEAL WITH THE SCOURGE, PROVIDED— Dr Arthur Latham next spoke. The ad- vances that have been made in the medical knowledge of this disease during the last ten of fifteen years have been so great, he said, that we are now in a position to deal with the scourge, provided that we get the LTOvernment. or municipal auinoriues, or still better, the people themselves to take the question up. Certainly the projected movement in Wales is by a long way the most important in this particular direction that we have had in the English Kingdom (applause). At the present day we know the cause of consumption. We can prevent it. We can detect its presence. And, if we are given a chance, in the great majority of cases we can cure it (applause). I would state as emphatically as I know how that consumption is in no way, whether directly or indirectly, a hereditary disease. Consumption is undoubtedly due to the presence of a minute micro-organism it is known as the tubercule bacillus. There are several forms-some derived from cattle, some from the human race, and also from other sources. No matter what degree of health a man may have, no matter how robust his constitution, if he receives a suffi- cient dose of the tuberculosis bacilli, he will undoubtedly contract consumption or some other form of tuberculosis. ONE MAN, AND ANOTHER. The readiness with which he becomes a prey to the tuberculosis bacilli depends to a very large extent upon his capacity for resisting disease. It is a precise parallel with the parable of the sower. If a man is healthy, if he lives under healthy and de- cent conditions, when the tubercular bacilli are in his neighbourhood, he does not fall a prey. The seeds falls on stony ground. If, on the other hand, a man's health is un- dermined by insanitary conditions—to which allusion has just been made, by disease, by alcoholic excess, by semi-starvation and what not, well, the tuberculosis bacilli falls on very fruitful ground, and the disease is the inevitable result. So it is quite clear that in any campaign against consumption, the general health of the nation is of the utmost importance. If the housing of the poor, or if the arrangements for sufficient open-air spaces within towns, are satisiac- tory, well, then-there is much less chance of the tubercular bacillus getting hold of the people. And that was put into words by the poet Cowper many years ago, when he said that God made the country, and men made the town." It is stated by the medical officer of the Local Government Board that no less than 20 per cent. of the milk supply of this coun- try contains living, virulent bacilli, which are capable of dealing death to those who drink them. That means one glass out of five seld across the counter in England and Wales to-day contains tubercular bacilli. The American Government analyst has found that in no less a proportion than one in ten of butter examined living tubercular bacilli are found. The remedy is very sim- ple. Provided the products of the cow are subjected to a temperature of 140 degrees Fahrenheit for twenty minutes, no tuber- cular baccillus will live, and the germs of the disease will be destroyed. It does not entail anything like the' expense of en- deavouring to remove all tuberculous cows from these islands would do. CRIMINAL MILK-SELLING. But I venture to say, when we have such a simple remedy for protecting us from the seeds of deadly disease like this, it ought to be a criminal offence to sell milk which contains living tubercular bacilli (hear, hear). The other sources of consumption are the consumptive people in England and Wales. Consumption is definitely an infective or in- fectious disease. But I don't want you to run away with the idea that every con- sumptive is necessarily a menace to his neighbours, and that he must be treated as a leper, because if that idea is carried out too far, we shall be doing a great injustice to many suffering persons. A man who has consumption, but who spits up no tubercu- lar bacilli, is not a danger in any way to anyone with whom he is brought into con- tact. The man, on the other hand, who is spitting up a large number of tubercular bacilli, is a constant menace to those with whom he is brought into contact. But if a man is not careless and will carry out sim- ple rules, then the dangers of infections are very, very small. Therefore, if we are to deal "with consumption in anything like a comprehensive way, we must have even- tually-and the sooner the better—compul- sory notification of the disease (hear, hear, and applause). DISPENSARIES TO DETECT. And we must also have some method for detecting the disease at its earliest possible stage. Hospitals, as conducted as present, are not up-to-date from the point of view of detecting consumption. If we are to do anything with regard to this crusade, I am certain from my experience in various coun- tries that it is absolutely necessary to es- tablish anti-tuberculosis dispensaries. A dispensary is comparatively cheap, costing from 9-500 to perhaps P,1,000 a year, and. serving something like 300,000 population, and capable of attending to 18,000 patients a year. The workingman can go there at any time—after his work is over. If the disease is detected, the nurse and the doctor attached to the dispensary visit the home. The wife, the children, and everybody brought into contact with the infected in- dividual are carefully examined. And in that way, in the dispensaries already es- tablished, no less than 40 or 50 per cent. of cases are detected in an early and curable stage., whereas by other methods they are allowed to drift on to an incurable stage. Further, the dispensary sees that the home is adequately disinfected, and the patient is properly trained as to what he is to do with the expectoration, so that he ceases to be a danger to others. And, as far as Possible, the dispensary aids a person who is ill by getting him into a sanatorium or elsewhere, and putting into action all the other voluntary associations, so there is no overlapping, and everything possible is done to the sufferer. It is a reflection on Eng- land and Wales that at the present time we have only one dispensary of this des- cription-at Paddington. STATE RAILWAYS SANATORIA. When you turn to what is done by sana- torium treatment, you :find that in the Prussian State railways sanatoria of the pa- tients discharged in 1900 at the end of the sanatorium treatment, not less than 53 per cent. were able to earn their own living in enjoyment of full working capacity at the end of five years. The value of sanatorium treatment is not confined to the individual at the sanatorium (hear, hear). Wherever a sanatorium is established, for a radius of ten miles around people learn to keep windows open and live more healthy lives (hear, hear). In addition, you find that the majority of men who derive so much bene- fit from the sanatorium treatment, are sent out as missionaries of health, and they do an enormous amount of good (hear, hear, and applause). Therefore, sanatoria are a very potent factor in any scheme for the prevention of consumption, perhaps more potent for the prevention than for the cure. We have a population of consumptives in England and .Wales of 250,000 to 300,000. I should estimate that you have in Wales to the number of at least 12,000. We have 1,500 beds for sanatoria treatment at the present time. Our accomodation amounts to 1 or perhaps 1! per cent. of what we 2 want. HOW MANY CAN AFFORD TO PAY ? But supposing we had more sanatorium accommodation, how many can afford to pay the necessary fees ? (hear, hear). There are 43,000,000 people in the United Kingdom. Only 2,000,000 of those, have an income of over £ 400 a year. Twenty-eight millions have an income of about E160-and they ob- viously would require assistance for any lengthy treatment. And there are 13,000,000 people in the country who are absolutely unable to afford a single penny if they be- come victims to this disease. So it is clear, if we are going to do anything with regard to consumption, we must have some form of insurance, whether voluntary or national. so that a man can insure himself against consumption, so that, when he does by chance suffer from consumption, he is in a position to obtain the treatment (aplause). I have it worked out actuarially, and I find that if everybody in this country from the age of 15 upwards was to contribute id a week, he would be in a position to obtain the necessary treatment for six months at a sanatorium. In England and Wales we have from all forms of tuberculosis 60,000 deaths a year, about one death every ten minutes. In Wales and Monmouthshire alone you have lost in the last ten vears 36.669 npnnlp In 1900, the loss was 3,650 in 1904, 3,742 in 1908, 3,754 in 1909, 3,611, so that prac- tically speaking, for the last ten years you have been absolutely stationary with regard to this disease. Also in Wales, at least one person in ten dies from consumption, which makes it emphatically worth while from the sentimental point of view to do what we can to get rid of this curse (applause). MONEY TALKS." In a great movement of this kind, unfor- tunately, sentiment is not always a very powerful weapon. In the expressive phrase from the across the water, Money talks (laughter). The German Government insti- tuted a German insurance system. After a time insurance companies found that their funds were being heavily hit by claims made by people suffering from various forms of sickness. It was found that. 50 ner cent. of these claims came from consumption, and it was seen that if that drain went on, these insurance companies must become bankrupt. Inquiries were made and the medical profession were taken into consulta- tion, and it was shown that by the estab- lishment of sanatoria much of this drain would in all probability be saved. The in- surance companies took the advice and es- tablished sanatoria on a large scale. And now, instead of being bankrupt concerns, they are in a flourishing condition, with large surpluses in reserve to their credit. The friendly societies in England and Wales pay out E4,000,000 a year for sick pay. £ 1,200,000 of that goes directly to con- sumptives. Under the poor-law of England and Wales, £ 1,400,000 is paid away annually so far as consumptives are concerned. Hos- pitals for chest, troubles, chiefly consump- tion, contribute- £ 500,000 a. year. So that we are in a position to show a direct loss of £ 3,000,000. When you take up the ques- tion of the loss of wages, the loss of life capital, etc., you can put an indirect loss of something like E4,000,000 or £ 5,000,000. So that we can say we are under-estimating it when we find in England and Wales no less than e8,000,000 is lost every year owing to consumption, and I estimate it at some- thing like F.400,000 a year for Wales. What do you get for this expenditure ? I venture to tell you that you get nothing except slight alleviation of human suffering, that you get practically nothing from the point of view of 'preventing consumption. If, however, you make prevention the keynote, well, you will stamp out the disease in the course of a generation, to the best of my belief (applause). If you spend 4:100,000 a year in Wales you will achieve the object, and you will be saved from spending one way or another, as you do at present, P-4,000,000 on the disease. Intelligent ex- penditure of less than it costs now will not only save countless lives and untold misery, will not only wipe out consumption from our midst, but will in course of time save millions of money. You want education, beginning in the the schools, lecturers going about the schools. You want a proper system of at- tacking the disease mainly by dispensaries. You want compulsory notification you want sanatoria accommodation and super- vision and after-care of patients who leave the sanatorias or who are too ill to go to sanatoria. If you do it, I am sure you will erect an abiding monument to the late King, who, when he was told at the time of the Tuber- culosis Congress in London in 1901, that consumption was preventible, asked in a very pertinent way, If consumption is pre- ventible, why is it not prevented ?" (hear, hear, and applause). And you will only raise a great monument to a great King, but you will do much to relieve suffering humanity, and you will one and all have the satisfaction in later years of being able to feel that you have lifted the shadow of death from many a humble home (hear, hear, and applause). MR. DAVID DAVIES DEFENDS THE VOLUNTARY MOVEMENT. Mr David Davies supported the resolution, and said that after hearing Dr Latham's eloquent address, we must feel with a sense of shame that we are hopelessly backward in dealing with this question of tuberculosis. We are asking for a very large sum, £ 300,000, and we hope that if this sum or more is forthcoming, the national movement will be an endowed movement,—(applause) —and that we shall not have to come year after year asking people to contribute an- unally towards the maintenance of the cam- paign. Every facility will be provided for people to subscribe in instalments, as well as to give lump sums. Up to the present no detailed scheme whatever has been prepared, because you will see the impossibility of laying down definite lines until we know how much money there is to be spent upon it. We can go so far as to say that the money would not be wasted, but that it would be spent in accordance with the best expert advice we can get on the subject. It is impossible to say now whether there should be one or two, or three or four or more sanatoria. But these sanatoria should be as inexpensive structures as possible, and should provide as many beds as possi- ble (applause). It is not the building it- self which costs such a lot, but the main- tenance of it afterwards. And we hope the friendly societies and various voluntary and public bodies will be able to see their way to guarantee a certain sum towards the maintenance of these buildings, and that they in return will be able to get so many beds for the particular areas which they cover. This is a voluntary movement, and al- though many people say that this question of tackling this problem of consumption is a matter that should be done by the State, I think that in tackling a great scourge of this kind voluntary effort and every other effort ought to go together,— (applause)—and the noblest thing we can do as individualists is to see that our country, instead of being the worst, is leading in a campaign of this kind (applause). WHAT CONSUMPTION COSTS MONT- GOMERYSHIRE. Dr C. E. Humphreys also supported the resolution, and mentioned that. the average death rate from tuberculosis in Montgom- eryshire during the last three years was about 1.5 per 1,000 of the population- slightly lower than the rest of Wales-or 83 deaths per year, or practically one in ten of the total number of deaths. At, a very low estimate, I have ascertained that con- sumption is costing Montgomeryshire be- tween £ 5,000 and £ 6,000 a. year. The resolution was carried unanimously. Mr D. Wintringham Stable then proposed that Mr J. E. Tomley, solicitor, Montgom- ery, be elected honorary secretary of the County Campaign Committee. Mr Richard Jones seconded, and, like the mover, spoke of Mr Tomley's peculiar qualifications and fitness to fill the office. The meeting unanimously adopted the proposal, and in accepting office, Mr Tomlev remarked that he had the consent of his principal, Mr C. S. Pryce (hear, hear) On the motion of Colonel Pryce-Jones, seconded by Mr Fairles Humphreys, repre- sentatives of all the public authorities and voluntary societies were appointed a com- mittee, with power to add to their number. A hearty vote of thanks was accorded to Sir Watkin for acting as convener and chairman of the meeting.






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