Morris tribune., 1913-04-04
NEED OF A HOSPITAL.
Its Importance in the Treatment
of Preventable Diseases.
By E. T. Fitzgerald, M. D.
Second Article.

a great deal about tuberculosis; the
instruction. most of it. is authorita-
tive. timely and important, and is
accomplishing results. Nevertheless,
when it is known that the total num-
Der of deaths in the United States
from the great white plague Call
forms) is approximately 151. 200,
while from the other. four diseases
just mentioned it is about 461, 900,
one must inquire why tuberculosis
should occupy the stage to the exclu-
sion of the other characters whose
parts must be played if the sequel is
not to be disappointing. Is not
man who has died of heart disease
Just as dead as the one from tuber-
culosis? True, the latter has had
with him the infective element in
larger measure and he is entitled to
the title role: the deaths from other
Infections disclose the real tragedy
of preventabIe disease.
"Heart disease" in about so per
a
acute endocarditis, inflammation of
heart valves.) Among go cases of
chronic heart disease at the Leipsic
clinic Germany 58.5 per cent fol-
lowed actue rheumatism. In the all
important endocarditic group of the
acute infections, rheumatic fever
plays the important role.
There is no single problem of great
er Importance in preventive medicine
than the reduction of the enormous
waste of life in children in con-
sequence of the rheumatic infection.
Here is one of the peculiarities of
mortality statistics: If a patient
with crippled heart contracts pneu-
monia. typhoid or other disease and
dies because his limited heart-power
is not sufficient to carry him through
the crisis, death is attributed to the
preceding acute disease.
If he dies from heart-disease some
time after apparent recovery from
the acute infection which caused it,
the latter is infrequently mentioned
as even contributory cause of death.
Hence we find the death.rate from
rheumatism only IA per 100. 900 of
population. while it is responsible for
more than one half the cases of
chronic heart-disease.
In no disease is it more important
than in rheumatism that the physician
''should be watchman all the
time'. for on the early detection of
heart complications may depend the
life or future usefuless of patient
If it were possible in the beginning
of the attack to remove patients with
p acute rheumatism from their homes
to hospitals near at hand and there
find proper diet and facilities for care
and treatment, including that i'm.
portant adjunct to modern medicine.
the trained nurse, all would be done
that can be done toward lessening the
severity of the attack, adding to the
comfort of the patient and preventing
the disastrous complications of which
heart. disease is the most common
Rarely. indeed, can one find in :
rural district patient with rheumatism
receiving the benefits of hospital. care
or one who can be prevailed on to pro
vide for himself early and suitable
nursing at home. or tolerate on tn,
part of the physician the watchfulnes
so necessary for sensible and success
ful treatment.
The rural pneumonia portion of th
health problem can Ee solved in part
at least, if suitable hospital provision
for its treatment can be made.
1t is well known that when we ar
dealing with this disease 'the scene
> change rapidly and the passage o
an hour or two may present an en-
tirely different picture. The obviou
lesson of this is that pneumonia pat
tents should be watched carefully an
: even by the attending physician q
frequent intervals. especially durin
the latter part of the disease, whe
judicious and well timed medicatio
may tide the patient over the crisi
to recovery.
How is the country physician t
follow this sound advice? The res
sons why he cannot are perfectly plai
to both the patient and the physician
: In cases of diarrhea and entiritis an
other children's disease, the rur;
hospital with its complement of visit
ing nurses. can materially help
solve the infant mortality part {
the health problem.
Space does not permit discussic
OF the whole question. yet your a
tention is called to one of its mino
but none the less important. elements
In 1910 there we're approximate
g 000 DEATHS from op,,andio;4i9 IN ~