Abstracts from Reports ANNUAL report tuberculosis varam, near INDIA), 1935-36
of
the
union
sanatorium, MADANAPALLE
mission arogya-
(SOUTH
The report gives a short history of the origin of the its situation, climatic conditions, accommodation and other activities. During the year 642 patients were treated, 421 were admitted and 422 were discharged. The group of Merchants' contributed to the highest number (65),
8anatorium,
the ' students' next (58). In the age group the highest number was in men between 21 to 30 years and in women
21 to 25 years.
Of the 422 cases discharged, 371 were suffering from active pulmonary tuberculosis. Of these, 51 were not included in the assessment for insufficient stay. The remaining 320 cases dealt with showed 14.4 per cent in stage I. 13.4 per cent in stage II, and 725 per cent in 56 were 'arrested', 110 stage III. Amongst all these ' ' much improved' and 61 improved' by the treatment,
262
THE INDIAN MEDICAL GAZETTE
that is ' positive' results were obtained in 70.9 per cent. In the stage I cases 98.0 per cent, in stage II cases 90.7 per cent and in stage III cases 61.5 per cent showed positive results. In these 320 cases sputum was found to be positive in 73.1 per cent. All those in stage I could be made free from the bacilli. The sputa of 5G.5 per cent of those in stage II and 29.9 per cent of those in stage III could be made negative to the bacilli. In the pneumothorax group (94) ' positive' results were obtained in 54.3 per cent. The author is very much impressed by its effect even in stage III cases. In this group in successful cases 50 per cent were much improved whereas in unsuccessful cases due to adhesions only 26.1 per cent were much improved. The author has found encouraging results in intestinal tuberculosis cases by ultra-violet and vitamin therapies. The most illuminating part of this report is the result of the investigation of after-histories of his He clearly showed the advancement in the cases. treatment of tuberculosis by modern methods. Amongst those treated during the years of 1915 to 1920, only ' 23.1 per cent were discharged as clinically well' and 35.5 per cent were alive and well after five years, whereas those treated during the years of 1926 to 1930, ' 34.3 per cent were discharged as clinically well' and 64.6 per cent were alive and well after five years. The group of 1921 to 1925 produced intermediate results. ' The groups of arrested ' and ' much improved ' were termed as ' clinically wellbecause the author found from after-histories of his cases that both those groups did equally well after their discharge from the sanatorium. P. K. S.
THE RAMAKRISHNA MISSION FREE TUBERDELHI. CULOSIS CLINIC, DARYAGUNJ, REPORT FOR THE PERIOD OCTOBER 1933 TO DECEMBER 1935
History.?The institution was started in a small rented house at Pahargunj in October 1933. Shortly afterwards it was noticed that most of the patients The clinic was. were coming from the city proper. therefore, moved to a larger house near Jama Masjid in August 1934. This place was also found unsuitable and in September 1935 the management transferred ' the clinic to the present building known as Hanging Bridgeclose to Daryagunj Post Office. It is a spacious, well-ventilated and well-lighted building very suitable for an institution of this nature.
Objects.?Before
the introduction of the
new
scientific
collapse therapy, sanatoria were considered to be the only places where this disease could be treated effectively, but medical opinion has changed considerably in recent years. Even comparative!}' advanced cases can now be treated successfully in an outdoor clinic. The object of this small institution is to offer the advantages of the most modern forms of treatment to poor consumptive patients. Necessity of a tuberculosis clinic in Delhi.?Once a civil surgeon of Delhi stated at a meeting of hi? colleagues that there was hardly a family in the city, which could claim to be altogether free from this disease methods, such
in
as
We have reason to think that he the truth. Under the circumstances it is impossible for a hospital with 70 or 100 beds to cope with the situation. We believe that outdoor clinics serve several purposes. Firstly, they treat those patients who do not obtain admission in the hospital. Secondly, the treatment of the patients discharged from the hospital can be continued in a clinic. Besides these two classes of patients, there is another class who will not go into a hospital. They also can have^ treatment in the clinic. Further, an outdoor clinic is the most suitable place for carrying out preventive work, which is the most important thing in fighting the an
was
active form.
not far from
disease.
'
?
[April, 1937
clinic is equipped with the instruapparatus to do artificial pneumothorax and phrenicectomy operations. Several such operations have already been performed in this clinic. Management.?The institution is managed by a working committee appointed by the local committee
Equipment.?The
ments and
of the Delhi Ramakrishna Mission. Maintenance.?In its earlier days, the clinic was maintained by monthly subscriptions and small donations from the general public. Subsequently, a grant-in-aid of lis. 1,050 from the King George Thanksgiving (Anti-Tuberculosis) Fund and lump suni donations, such as lis. 2,000 from the Maharaja of Vizianagram, Its. 500 from Seth G. D. Birla, and lis. 500 and lis. 300 from two anonymous donors, have so far enabled this useful institution to cariy on the workUnfortunately the monthly subscriptions have gradually fallen to an insignificant amount. As a result, the recurring expenses are being met from the donations. Consequently, the sum acquired from donations has been sadly depleted and unless other sources of revenue are made available it will be very difficult, if not impossible, for the clinic to continue its existence much less make the badly-needed expansion. It is very difficult to secure a suitable house for an institution of this nature. Most house-owners are afraid of the word tuberculosis; so we always feel a sense of insecurity of tenure. For this reason m particular, there is urgent necessity for the clinic to have a building of its own. In such an event, current expenditure will be reduced considerably and it win add to the stability of the institution. Besides a house of its own, the clinic has other requirements, such as an ultra-violet ray apparatus, an operating table, a sterilizer, a microscope and other _
ordinary laboratory requisites.
Through
the kind offices of Lieut-Col. W. C. Pat on, ungrudging services of Dr. S. C. Sen and Dr. A. C. W. Dessa, z-ray examinations of our patients are being done either free or at a nominal cost. The work is rapidly increasing and it is likely that in the near future these gentlemen may find it impossible to meet the demands of our work. Hence it may be necessary for us in the near future to install an z-ray set. At present all laboratory examinations, including routine examinations, are being done by Dr. S. K. Sen; free of charge. It is too much to ask him to continue this help for long. We feel the necessity of a small laboratory of our own, equipped well enough for doing the routine examinations of sputum, urine, etc. Preventive work.?This disease spreads mostly by direct contact. Hence the most important part 0' preventive work lies in tracing patients suffering from the disease, and their contacts. This task becomes easy in an outdoor clinic. Further, as these patients ?e' treatment in the clinic, they are under some obligation to the institution, and the staff gradually gain their confidence. As a result, these patients and their relations are not likely to raise objections to us visitinS their houses and adopting such measures as are deeme" necessary for carrying on the preventive work. In 1934 the clinic obtained a grant-in-aid of lis. 1,050 from the King George Thanksgiving (Anti* Tuberculosis) Fund for this purpose. A paid lady doctor was engaged specially for this work. Unfortunatelythe grant was discontinued next year on the ground that a lad}' health visitor was not employed for doing the work. No lady health visitor was available at that time in spite of every possible effort on our part t? secure one. The services of the lady doctor had to be dispensed with for want of funds.
c.M.o., and the
Subsequently, owing
attending
impossible
the
clinic,
to the
the
rapid increase of patients honorary staff found jt #
adequate attention to preventive work. At present, excepting the distribution ?l booklets?'Instructions to Tuberculosis Patients'?an? the giving of verbal instructions to the patients an" their contacts, very little is being done in this directionto
pay
of
the
union
sanatorium, MADANAPALLE
mission arogya-
(SOUTH
The report gives a short history of the origin of the its situation, climatic conditions, accommodation and other activities. During the year 642 patients were treated, 421 were admitted and 422 were discharged. The group of Merchants' contributed to the highest number (65),
8anatorium,
the ' students' next (58). In the age group the highest number was in men between 21 to 30 years and in women
21 to 25 years.
Of the 422 cases discharged, 371 were suffering from active pulmonary tuberculosis. Of these, 51 were not included in the assessment for insufficient stay. The remaining 320 cases dealt with showed 14.4 per cent in stage I. 13.4 per cent in stage II, and 725 per cent in 56 were 'arrested', 110 stage III. Amongst all these ' ' much improved' and 61 improved' by the treatment,
262
THE INDIAN MEDICAL GAZETTE
that is ' positive' results were obtained in 70.9 per cent. In the stage I cases 98.0 per cent, in stage II cases 90.7 per cent and in stage III cases 61.5 per cent showed positive results. In these 320 cases sputum was found to be positive in 73.1 per cent. All those in stage I could be made free from the bacilli. The sputa of 5G.5 per cent of those in stage II and 29.9 per cent of those in stage III could be made negative to the bacilli. In the pneumothorax group (94) ' positive' results were obtained in 54.3 per cent. The author is very much impressed by its effect even in stage III cases. In this group in successful cases 50 per cent were much improved whereas in unsuccessful cases due to adhesions only 26.1 per cent were much improved. The author has found encouraging results in intestinal tuberculosis cases by ultra-violet and vitamin therapies. The most illuminating part of this report is the result of the investigation of after-histories of his He clearly showed the advancement in the cases. treatment of tuberculosis by modern methods. Amongst those treated during the years of 1915 to 1920, only ' 23.1 per cent were discharged as clinically well' and 35.5 per cent were alive and well after five years, whereas those treated during the years of 1926 to 1930, ' 34.3 per cent were discharged as clinically well' and 64.6 per cent were alive and well after five years. The group of 1921 to 1925 produced intermediate results. ' The groups of arrested ' and ' much improved ' were termed as ' clinically wellbecause the author found from after-histories of his cases that both those groups did equally well after their discharge from the sanatorium. P. K. S.
THE RAMAKRISHNA MISSION FREE TUBERDELHI. CULOSIS CLINIC, DARYAGUNJ, REPORT FOR THE PERIOD OCTOBER 1933 TO DECEMBER 1935
History.?The institution was started in a small rented house at Pahargunj in October 1933. Shortly afterwards it was noticed that most of the patients The clinic was. were coming from the city proper. therefore, moved to a larger house near Jama Masjid in August 1934. This place was also found unsuitable and in September 1935 the management transferred ' the clinic to the present building known as Hanging Bridgeclose to Daryagunj Post Office. It is a spacious, well-ventilated and well-lighted building very suitable for an institution of this nature.
Objects.?Before
the introduction of the
new
scientific
collapse therapy, sanatoria were considered to be the only places where this disease could be treated effectively, but medical opinion has changed considerably in recent years. Even comparative!}' advanced cases can now be treated successfully in an outdoor clinic. The object of this small institution is to offer the advantages of the most modern forms of treatment to poor consumptive patients. Necessity of a tuberculosis clinic in Delhi.?Once a civil surgeon of Delhi stated at a meeting of hi? colleagues that there was hardly a family in the city, which could claim to be altogether free from this disease methods, such
in
as
We have reason to think that he the truth. Under the circumstances it is impossible for a hospital with 70 or 100 beds to cope with the situation. We believe that outdoor clinics serve several purposes. Firstly, they treat those patients who do not obtain admission in the hospital. Secondly, the treatment of the patients discharged from the hospital can be continued in a clinic. Besides these two classes of patients, there is another class who will not go into a hospital. They also can have^ treatment in the clinic. Further, an outdoor clinic is the most suitable place for carrying out preventive work, which is the most important thing in fighting the an
was
active form.
not far from
disease.
'
?
[April, 1937
clinic is equipped with the instruapparatus to do artificial pneumothorax and phrenicectomy operations. Several such operations have already been performed in this clinic. Management.?The institution is managed by a working committee appointed by the local committee
Equipment.?The
ments and
of the Delhi Ramakrishna Mission. Maintenance.?In its earlier days, the clinic was maintained by monthly subscriptions and small donations from the general public. Subsequently, a grant-in-aid of lis. 1,050 from the King George Thanksgiving (Anti-Tuberculosis) Fund and lump suni donations, such as lis. 2,000 from the Maharaja of Vizianagram, Its. 500 from Seth G. D. Birla, and lis. 500 and lis. 300 from two anonymous donors, have so far enabled this useful institution to cariy on the workUnfortunately the monthly subscriptions have gradually fallen to an insignificant amount. As a result, the recurring expenses are being met from the donations. Consequently, the sum acquired from donations has been sadly depleted and unless other sources of revenue are made available it will be very difficult, if not impossible, for the clinic to continue its existence much less make the badly-needed expansion. It is very difficult to secure a suitable house for an institution of this nature. Most house-owners are afraid of the word tuberculosis; so we always feel a sense of insecurity of tenure. For this reason m particular, there is urgent necessity for the clinic to have a building of its own. In such an event, current expenditure will be reduced considerably and it win add to the stability of the institution. Besides a house of its own, the clinic has other requirements, such as an ultra-violet ray apparatus, an operating table, a sterilizer, a microscope and other _
ordinary laboratory requisites.
Through
the kind offices of Lieut-Col. W. C. Pat on, ungrudging services of Dr. S. C. Sen and Dr. A. C. W. Dessa, z-ray examinations of our patients are being done either free or at a nominal cost. The work is rapidly increasing and it is likely that in the near future these gentlemen may find it impossible to meet the demands of our work. Hence it may be necessary for us in the near future to install an z-ray set. At present all laboratory examinations, including routine examinations, are being done by Dr. S. K. Sen; free of charge. It is too much to ask him to continue this help for long. We feel the necessity of a small laboratory of our own, equipped well enough for doing the routine examinations of sputum, urine, etc. Preventive work.?This disease spreads mostly by direct contact. Hence the most important part 0' preventive work lies in tracing patients suffering from the disease, and their contacts. This task becomes easy in an outdoor clinic. Further, as these patients ?e' treatment in the clinic, they are under some obligation to the institution, and the staff gradually gain their confidence. As a result, these patients and their relations are not likely to raise objections to us visitinS their houses and adopting such measures as are deeme" necessary for carrying on the preventive work. In 1934 the clinic obtained a grant-in-aid of lis. 1,050 from the King George Thanksgiving (Anti* Tuberculosis) Fund for this purpose. A paid lady doctor was engaged specially for this work. Unfortunatelythe grant was discontinued next year on the ground that a lad}' health visitor was not employed for doing the work. No lady health visitor was available at that time in spite of every possible effort on our part t? secure one. The services of the lady doctor had to be dispensed with for want of funds.
c.M.o., and the
Subsequently, owing
attending
impossible
the
clinic,
to the
the
rapid increase of patients honorary staff found jt #
adequate attention to preventive work. At present, excepting the distribution ?l booklets?'Instructions to Tuberculosis Patients'?an? the giving of verbal instructions to the patients an" their contacts, very little is being done in this directionto
pay
