London's Pulse: Medical Officer of Health reports 1848-1972

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Greenwich 1964

[Report of the Medical Officer of Health for Greenwich Borough]

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Prevalence of, and Control over, Infectious
and Other Diseases
Treatment of infections by the use of drugs has its origins in
antiquity. Specifics evolved and febrile conditions were countered
with quinine, looseness of the bowels with ipecacuanha and
emetine and syphilis with mercury compounds. Chemotherapy,
the term given to this type of treatment, is today much more
extensive and extremely successful but it required the discoveries
of Pasteur, Lister and Koch in the field of bacteriology and the
advances in chemistry of Perkin and Ehrlich for its full potential
to be realised. Five years after the discovery of the causative
organism of syphilis in 1905, came the curative arsenical compound
known as "salvarsan" but it was not until the middle 1930's that
this advance was exploited and the therapeutic value of a synthesized
dye against streptococcal infection was demonstrated.
Other drugs such as sulphanilamide made their appearance to be
quickly followed by more sulphonamides, but the discovery of
penicillin in 1928 by Fleming led to the introduction, albeit very
leisurely it seems, of a completely new range of substances known
as antibiotics. An antibiotic is a substance produced by one form
of living organism which is pathogenic to another and, although
the world had to wait until 1939 before the value of penicillin was
firmly established, there was a subsequent intensive search for
other similar substances which led to the introduction of streptomycin,
Chloromycetin, and aureomycin, the first of the tetracyclines.
Relatively speaking, however, immunology is a product of more
modern times. As far back as the 1850's there was only one disease
against which immunity could be given, namely, smallpox and even
this had to be introduced on a compulsory basis in 1853. Again,
society had to wait for the growth of bacteriology and the experiments
of Pasteur and others before further protection could be
offered. Since then, and with the emergence of toxoids, routine
immunity procedures have been introduced for use against diphtheria,
tuberculosis, typhoid, cholera, yellow fever, whooping
cough, tetanus and poliomyelitis and there is good reason to think
that measles will shortly join this list.
The whole theory and practice of substitution therapy which
is saving countless lives, rests upon the isolation in earlier years
of substances such as insulin, cortisone, thyroxin and the oestrogens,
whilst many a patient suffering from a deficiency disease will live
a normal life following the discovery of the "vitamines" at the turn
of the century.

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