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5
What, if anything, can be done to prevent this wastage of the manpower
of the Nation, for the experience in Battersea is paralleled by the
experience of the Country in general. More particularly it may be
asked what can Public Health Departments, whose duty it is to safeguard
the health of the community, do. Unfortunately, the answer must
be that at the present time there seems to be comparatively little that
we can do. As I pointed out in my earlier Report, there may well be
social and environmental conditions at present not known which account
for the high prevalence of deaths from this disease in these age groups.
A great deal of research in many countries of the world is being carried
out, but the problem is one of considerable magnitude and complexity,
The effect, or possible effect, of such factors as diet, exercise and
occupation, have been carefully looked into, without so far any final
opinions being arrived at. Bio-chemical investigations have suggested
that one factor may be a disordered state of the fatty constituents of the
blood and other tissues, arising possibly from dietary causes. When
large amounts of fatty foods, particularly animal fats, are taken over
many years, it is suggested that this disease may arise, although clear
Proof is lacking. The effect of exercise and of the type of work in
relation to exercise has been looked into, and there is some reason to
think that people working in active routine occupations may be less
likely to become victims than those engaged in more sedentary occupations.
However, these researches, at the moment, do little more than
provide pointers to the more definite answers which undoubtedly will
emerge in due course. In the meantime, what can be done in the
light of existing knowledge to prevent this form of heart disease? No
categorical answer can be given to this question, but observance of
what are usually recognised as the rules of health may at least do something
to avert this illness, and certainly can do no harm. Regular habits,
steady work within the individual's capacity, reasonable outdoor exercise
in relation to age and fitness, temperance in eating, particularly of fatty
foods,and drinking, are all facets of the kind of life which most ordinary
sensible people would in any case follow. Nevertheless, it is the case that
people who conform to these rules may become victims of the disease,
whereas others who prefer to ignore them, and live a more unrestricted
king of life, may be affected; which merely serves to emphasise that
there is great deal yet to be learnt about diseases of the coronary
The number of notifications of tuberculosis in 1958 was 75,
pared with 100 in 1957. 67 other cases came to our notice otherwise
than by notification. As is well known, there has been, in the last
decade a considerable improvement in the outlook for tuberculosis. In
some ways the number of deaths from this disease gives a better indication
of the Progress that has been made in controlling it than the notifications,
and the figures are striking. For instance, in 1958 there were 17 deaths
from pulmonary tuberculosis, compared with 44 deaths in 1950. A better
idea of what is happening in the field of chest diseases generally can be
obtained by comparing the deaths from pulmonary tuberculosis with
other chest diseases, particularly lung cancer and bronchitis. In 1958,
there were 69 deaths from lung cancer in Battersea, compared with 36
in 1950.In regard to bronchitis, in 1958 there were 87 deaths compared
with 80 in 1950. In other words, while there has been a marked
reduction in the number of deaths from tuberculosis in the 8 years from
1950, there has been an equally marked increase in the number of deaths
from lung cancer, whereas the number of deaths from bronchitis has