" Addressjtf. each other, What is the cause which this year most urgently demands our help ? " 1 think you will with me that the one THE SEGREGATION OF CONSUMPTIVES. agree paramount, prob- lem which to-day confronts us is the suppression The Annual Discourse Delivered before The of tuberculosis, and that this is the cause which Massachusetts Medical Society, June 12, 1907. now calls most loudly for our united and hearty ALLEYNE support. BY J. F. ADAMS, M.D., PITTSFIELD, MASS. The that it is to exterminate; Mr. President and Fellows the knowledge possible of Massachusetts this scourge of our race has deeply stirred the Medical Society : minds of men and flooded the world with the — The physician's path, though a good one to fol- light of a new hope. A mighty war is now in prog- low, is neither smooth nor easy. His life is a war- ress— a war which is uniting under a common fare, from the diploma to the grave a warfare banner people of every race, color, language, demanding the constant use of all his—powers, but nationality, class, party and creed. Already have whose visible rewards arc not commensurate with notable victories been won, but we arc still in the his expenditure of force. He strives not for him- early stages of the campaign, and it will require; self, but for others, and others enjoy the fruits of years of valiant and united onslaught to rob tu- his victories. But this fact does not deter men berculosis of its terrors. Meantime, the people from entering our profession. Rather eloes it look to us for leadership; and it is incumbent upon tend to draw into it those who wish to lead fruitful us to consider, year by year, what battalions arc lives, and it gives to the medical vocation a satis- to be organized, what engines of war constructed faction which is beyond all material returns. The and what tribute levied upon the community for physician is not a soldier of fortune, seeking only the successful conduct of the campaign. gold and glory, but a crusader enlisted 'in the As a contribution to the discussion of this sub- army of God, and lighting for the rescue of suffer- ject, 1 will ask you to consider with me that one ing humanity. This is the crowning glory of the of its branches which seems to me of the; highest doctor's life, and it is this unselfishness which en- importance, namely, the prevention of con- nobles his profession, and gives him a great and sumption by the separation of the sick from the peculiar influence— an influence which is gener- well. ally recognized by the community and which Since pulmonary tuberculosis is known t > be brings him great opportunities for usefulness. actively infectious, through a specific germ, it is Thus it comes about that a medical practitioner perfectly evident that the isolation of all infected is, to a greater or less extent, a missionary. He persons would, in a few years, stamp it out. It is always finding and doing some work, unpaid is the leprosy of our time; and, as leprosy is kept or underpaid, for his fellownien, because his train- under control by the segregation of lepers, so ing and his position rentier such work possible and may consumption be eradicated by the segrega- natural. 1 n freely serving the poor, in their homes tion of consumptives. or in hospitals, his opportunities for good arc not Let us suppose all the power in our country to exhausted. In all philanthropic measures he is be centered in a despot of unlimited power and to be relied upon as a helper, and in those directly wealth, and also filled with a burning desire to con- pertaining to the public health, he is naturally a fer great blessings upon his subjects. Such an one leader. He has unc;qualc;d facilities for dissémi- might say, "Consumption is the greatest enemy nât ing knowledge, for awakening interest and for of my people. I will destroy it, and that quickly." guiding benevolence. The evidences of this in- Could he do it? He could; and how? He would fluence are to be seen on every hand. Have you order the formation of many great camps, or en- not all exerted it? and have not your laborious closures, where all consumptives would be forcibly lives been brightened and sweetened by your colonized. These would be placed not far from suce:css? the cities and towns, but far enough to find pure If the influence of the physician in his individ- air and sunshine. There would be tents, cabins ual capacity is so great, how much greater must or shacks for the incipient cases, and hospitals for be that of the profession as a whole ! When this the advanced. There would be ample space and acts as a unit great, things can be accomplished, much freedom wit hin the camp, but no passing the and our medical societies render such action pos- bounds. Here many early cases and some of the sible. This organized force has done good work advanceel ones would be restored to health and in the past: it has persistently opposed error with be permitted to return to their homes, while those truth, ignorance with knowledge, charlatanry with who must die would have their illness brightened science; it has given to the world the benefit of by good care and every possible alleviation. By those marvelous discoveries of the past century this removal of consumptives, infection would which have prevented untold suffering and res- cease, and since the patients would no longer leave cued millions from death; and it stands ever the disease as a legacy to their families, new cases ready to champion every good cause whose ob- would grow fewer and fewer. The change in ten ject is to save human lives and make them better years would be marvelous, and if our supposed worth living. despot should live to the good old age he would It is therefore the thing to be expected that we, deserve, hewould see his camps nearly deserted and Fellows of The Massachusetts Medical Society, on consumption dwindling to an insignificant place this our anniversary, should ask ourselves and in the mortality tables. At the ene! of his bench- The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org by JOSH ROSENFELD on April 25, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. cent reign, his grateful people would erect a monu- cases. A " Commission to investigate measures ment inscribed with these glorious words, " To for the relief of consumptives " was appointed a the Conqueror of Consumption." year ago, and presented its report last March. The clay of despots has now gone by, but the So admirably was this report prepared, so wise power which they wielded still remains, vested were its suggestions and so convincing were its in the people, and the people arc able to accomplish arguments, that already has the legislature passed this same result. When once they are educated bills carrying into effect nearly all of its recom- up to the idea, when they fully understand that mendations. These bills provide, first, for the the thing can be done and that the doing of it immediate construction of three infirmaries for will save multitudes of lives and remove one of tubercular patients, of 150 beds each; second, the chief causes of suffering, poverty and sorrow, for the appointment of state inspectors of health; will there not be a great popular uprising, when third, for compulsory registration of cases; and the people themselves will demand the enforce- fourth, for giving greater effect to the anti-spitting ment of this act of elcpofism, which will separate law. Surely this is a remarkable result. A coin- the infected from the uninfccteel, to the end that mission which has brought the enactment, in a the plague may be stayed? They will be a little single session, of so many beneficent laws is en- longer about it than our despot would have been, titled to our gratitude and admiration. Three measures too arbitrary and violent might en- of its six members arc Fellows of The Massachu- gender— sedition and wreck the treasury, and setts Medical Society, and it is fitting that their they will try to bring about the desired —result names should be mentioned and remembered. without too much restraint of personal liberty They arc Dr. H. P. Walcott, Chairman of the and without danger of financial disaster, but in Commission and Chairman of the State Board of good time this thing will be done. It is safe to Health, Dr. A. S. MacKnight of Fall River, and prophesy that the clays of tuberculosis are num- Dr. C. S. Millett of Brockton, Secretary of the bered and that future generations looking back Commission. Their lay associates are Messrs. upon our time will say, " There were giants in Braekett, Adams and Porter. those days, for they destroyed that arch-enemy, To this roll of honor should be added (he name consumption." of Senator Frank M. Chace, of Fall River, who Through the untiring efforts of a great number had charge of the "Three Sanatoria" bill; of ' of medical men, and some very earnest laymen, Ex-Representative Googins, of Cambridge, who the people are being taught the value of local for four years, from 1901 to 1904, tried to secure associations, of medical inspection, of visiting the passage of a similar bill, and of Senator nurses, of anti-spitting regulations, of disinfection Frank G.