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Title: A study of tuberculosis in a county borough
Author: Murray, J. O.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1924
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Pulmonary Tuberculosis is as virulent and fatal a disease as formerly. The death rate has decreased on account of a lessened incidence. The Tuberculosis Scheme has assisted considerably in this decrease, especially in its educational effect. Pulmonary Tuberculosis is closely associated with a poor dietary, and industrial occupations. If is a disease of adolescence and the working periods of life. If tubercle bacill are in the sputum it is very rapidly fatal. Practically all cases of pulmonary tuberculosis are fatal within five years. Non-Pulmonary Tuberculosis. The death rate is reduced to an even greater extent than the death rate from pulmonary tuberculosis. This more marked decrease is partially due to the Infant Welfare Centre and School Medical Inspection. Always fatal under one year of age, recovery is most apt to occur, if infection occurs in age period between 5-15 years. Overcrowded Areas - Slums. The more densely populated an area the more liability is there to tuberculosis. Overcrowding In Private Families - According to Number of People per Room. Overcrowding has no direct relationship with the incidence or mortality of tuberculosis. Overcrowding according to the number of people per room is not a true measure of the existing conditions, as no consideration is paid to the cubic space available for each person. SIZE OF HOUSE (number of rooms.available). This is usually a good indication of social status, financial condition, and extent and suitability of dietary of the household. There is a very definite relationship between the size of the house and the incidence of pulmonary tuberculosis. The virulence and infectivity of the disease does not vary, but the population from small houses form a soil which is much more susceptible to infection. The chief factors in the production of tuberculosis are poverty and poor dietary, and lack of fresh air and sunlight. Such conditions allow the successful invasion of the tubercle bacilli which is the other contributing factor in the production of the disease. 'Lowered Resistance' is the important factor in the production of tuberculosis. Anti-tuberculous measures meet with only a small amount of success in slum areas. Notification is unsatisfactory in that early cases are not obtained. There is a lack of appreciation, in an industrial Population, of the necessity of early treatment. Sanatoria cannot he used for early cases - the early cases do not appear voluntarily, and when found will not he forced into sanatoria as long as they are earning noney. The result is, sanatoria are filled with cases too advanced for recovery. The fault is not with notification. It is due to the lack of provision which can be made for the family while the wage-earner is receiving treatment. Too many cases are notified who are non-tuberculous. Home Visiting. For successful results, at least two whole time visitors are necessary for every 100 cases occurring annually. If the education of the household in anti-tuberculous measure is to he put into practice the household must he moved from slum areas, and houses with two or three rooms. To accomplish this, financial assistance will he necessary in most cases. Sanatorium Treatment produces excellent results in children, hut poor results in the wage-earning population. All children do very well under treatment, and the results are usually sustained on their return home. They are not wage-earners. More sanatorium beds for tuberculous children are necessary. Cases from the wage-earning population have in addition to the disease, the responsibility of maintaining the household. This results in late treatment and poor or no results. It is preferable to abandon treatment for such cases. They should be moved, if necessary, into a satisfactory house and treated at home, with some financial assistance from the Tuberculosis Department. In this way early treatment is a possibility. Satisfactory employment must be found for them when they are able to work. Also under such conditions the family can be more efficiently guarded from infection. Sanitorium treatment for wage-earners prolongs life; it also prolongs the period of infectivity. Treatment should be effective at home for this section of the population. Sanatoria train: the treatment of wage-earners fails under existing circumstances. The Condition of the Sputum in Pulmonary Tuberculosis. Very few infected children have tubercle bacilli in the sputum. If tubercle bacilli are present in the sputum, death usually occurs within five years. If no tubercle bacilli are present the duration of life is usually longer. As regards treatment, there is no advantage gained in sending adults with no tubercle bacilli in the sputum to sanatorium from a working class population. The training obtained is valuable however. The eradication of poverty; poor diet; and ignorance in personal hygiene, must be the chief aims in a successful anti-tuberculosis campaign. In other words the resisting powers of the industrial population must be increased.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available