Respiratory diseases, as affecting the New Zealand Expeditionary Forces serving in France and United Kingdom: an analysis of the histories of 2433 men boarded as unfit for further service, June 1916 to December 1918

Abstract

#1.The outstanding feature of the Respiratory Diseases affecting men of the N.Z.E.F, has been their low immunity to attack by the organisms of catarrh. #2.This was one of the main causes of invaliding. The frequency of catarrhal attacks with lesions similar to Tubercular disease of the lungs was pronounced. #3 The percentage of Positive Tubercle of the lung is found to be about that of the British Army pre- war, taking statistics for 1913. #4.It was necessary to evacuate invalided men to New Zealand. This meant a long sea voyage of over six weeks in a crowded Transport.Thus it became necessary to use great care in classification,and the cases diagnosed Clinical Tubercle of the Lung amounted to a large number. #5.The improvement under changed conditions was rapid,and to avoid the stigma of Tubercle, the class of Chronic Pulmonary Disease Indeterminate was instituted.Men with the lesser apical changes were included in this class. #6.Comparison of histories as provided in Board Papers (Table 7) shows the similarities and variations in the three types of case. #7.The matter of diagnosis is open to question,and will be viewed by critics according to the value placed on Clinical signs and symptoms apart from the finding of the Tubercle Bacillus. #8.Tubercular diseases in New Zealand are not common. The view that the Clinical and CPDI cases are due to lighting of old foci in the lungs is not substantiated, but deserves consideration. #9. Sputum examinations shewed the presence of respiratory catarrhal organisms without the presence of T.B and it is probable that even the typical apical lesions are set up by the former alone. #10. The fact that the men were evacuated if still unfit for service after a period of three months or more,probably prevented the developetent of T.B.in a greater ratio. By watching the future of the suspects ,fresh grounds for opinion will arise.In the meantime the men should not be lost sight of. #11. The class CPDI was composed of two groups as in Clinical and Positive T.B. - those arising insidiously,and those in which the lungs gave persistent apical signs following an acute pulmonary attack (Table 3). #12. Influenza was not found to be so common a cause in these alas es as might have been expected.Slighter attacks of gas poisoning may have had something to do with the impairment. #13. Of other pulmonary diseases a group may be made of Pneumonia, Broncho-Pneumonia, and Pleurisy, including the cases of acute onset in the form which have been returned under T.B.(Positive and Clinical) and CPDI - This type of case shows a total of 694. #14.The Maori soldiers were very subject to Tubercle of the lung :their return for a small force is large. They affect the Ratios per 1000 in the Tables to some degree, and they are differentiated in important points. #15. Figures re: Age incidence shew that the acute diseases are more prominent in the years up to 25, for the acute. conditions - The experience of combatant of officers that men between 25 and 35 years of age are the best soldiers is upheld. In the later ages Asthma and Emphysema are more apparent. #16. Indoor and Outdoor occupation are not well defined among the agricultural population of New Zealand,where the towns are, small ,and short working hours allow of open air exercise .The Outdoor population includes a number of men who are much exposed to the weather and develop Bronchitis and Emphysema in their later years, while the figure for Pneumonia is high at all ages