A study of the relation between the treatment of tubercular patients in general institutions and the reduction in the death-rate from tuberculosis : report / by Arthur Newsholme.

  • Newsholme, Arthur, 1857-1943.
Date:
[1905]
Catalogue details

Licence: In copyright

Credit: A study of the relation between the treatment of tubercular patients in general institutions and the reduction in the death-rate from tuberculosis : report / by Arthur Newsholme. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    present in varying proportion, the same approximately exact propor- tion between institutional treatment of phthisis and the reduction in the death-rate from this disease will he visible. It may be claimed however that if similar facts hold good in other parts of Great Britain, we have indicated here a means of preventing the spread of phthisis which as such has been in unrecognised operation to a steadily increasing extent ever since the causes of death began to be regis- tered and which must have exercised a most beneficial influence to this end. In Ely, as already seen, the decline in the death-rate from phthisis has been much less than in Chichester. By the courtesy of the Registrar General I am able to state that in Chichester the proportion of total deaths from phthisis occurring in the workhouse was 12.2 per cent in 1861-65 and 24,7 per cent in 1886-90, while in Ely it Avas 1.6 in 1861-65 and 2.7 per cent, in 1886-90. Dr. Downes, Medical inspector of the Local Government Board for poor law purposes, states that in 1899, there occurred in the workhouse infirmaries of London 2800 deaths from phthisis, or 55 per cent of the total mortality from this disease in London. In Kensington during the nine years 1894-1902, 51.2 per cent of the total deaths from phthisis occurred in its workhouse infirmary. In Brighton we have seen that the proportion of total deaths of consumptives in the infir- mary has increased from 1/10 in 1861-70 to 1/5 in 1901-04. These patients pass a large share of their invalid and pre-eminent- ly infectious life in these institutions before death. As bearing on the value of such a method of treating the sick poor, which has been perseveringly pursued by most Boards of Guardians during the last forty years, it must be borne in mind that the administration of work- houses has steadily improved. Each year in an increasing number infirmary accommodation for the sick has been provided, separate from the workhouse for the ablebodied; and in the infirmary itself there has been an increasing practice of treating the consumptives in wards separate from other patients. The statistics already given show tha.t in Great Britain the average proportion of institutionally treated paupers to population has remain- ed about the same, in the midst of a decline of total paupeidsm. In 1902 in England and Wales total paupers formed only 1/40 while in 1848-49 they were 1/16 of the total population. But it is also true that the proportion of sick to healthy paupers who arc instilutionallv relieved has steadily increased; and we know that tuberculosis is one of the chief causes of sickness. We know furthermore that phthisis is spread to a disproportionate extent in crowded tenements occupied by those who are the most likely to become the recipients of poor- law relief. In view of these considerations, 1 have no hesitation in attaching greal value lo workhouse infirmaries as one of the chief