Conference of Officers in Charge of Government Hospitals Serving Veterans of the World War
History
Conference of Officers in Charge of Government Hospitals Serving Veterans of the World War
Medicine, Military; Military hospitals; World War, 1914-1918 -- Veterans -- Medical care -- United States
The subject of occupation in connection with T.B., is not only an
extremely important one but an extremely difficult one to administer,
particularly in the large government institution, and especially in
connection with the psychology of the ex-service man, which has been
referred to a number of times. He is apt to misunderstand and to be
resentful toward any application of work; and yet at the same time, if
we are going to measure the results of the sanitarium treatment of T.B.
by the functional restoration to activity and usefulness, we still find
that it results in a great many failures. That has been one of the
complaints on the part of T.B. workers not only in government but in
civil institutions as well.
We still find relapses occurring after the patient has been discharged
from the sanitarium or T.B. hospital. Men go into training, and in a
short time undergo another course of treatment, and so on. The reason
for that is that they have not been given the necessary physical
rehabilitation while still in the sanitarium, while under institutional
protection and medical supervision.
The question of occupation is so broad that it is impossible to take it
up extensively here today. We can point out one or two of the basic
principles in connection with its application in the treatment of T.B.
One very important feature brought out this morning is the
psychotherapeutic object,—the point of view of relaxation or recreation,
that is, giving the man something to occupy his mind and improve his
morale, helping him to forget his home anxieties and anxiety about
compensation.
The second point, or 2 A, deals with muscular reconstruction,—conversion
of recently acquired adipose tissue into working force by rebuilding
flabby muscular tissue which has resulted from the long period of rest.
2 A is the acquiring of a tolerance for T.B, toxins. This is important.
We do know that in the recently toxic stage, exercise or work does
produce a reaction which is shown by a rise in pulse rate. We know that
if exercise is begun in small doses and gradually increased, the time
will come when the patient can be made to take a fairly large amount of
exercise continuing over a fairly long period of time, without
manifesting the symptoms of reaction. Formerly we gave Tuberculin in
gradual doses until we reached the point where the man could take an
injection which surely would have killed him at the beginning of the
course. The main point is if a man leaves the sanitarium before he
reaches this toxin tolerance, he is more likely to break down. This is
the reason for the man’s frequently returning to the sanitarium for
treatment.
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