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disease is found more often in patients where the level of
the blood cholesterol is relatively raised.
Logically, the restriction of fat in the diet, especially that of
animal origin, would appear to be indicated to control its deposit
in the walls of the arteries. However, as cholesterol is an essential
part of the blood and is manufactured by natural processes
irrespective of fat intake, it is possible that it may be altered little
by a control of fat in the diet. Nevertheless, the clotting power
of blood has been proved to increase substantially after a fatty
meal and it must be remembered that the most serious aspect
of atheroma is the clotting of blood in the diseased blood vessels.
Therefore, on this point alone, a reduction in dietary fat could
be considered reasonable. One drawback to this regimen is that
food not only becomes unpalatable without fat, but as fat is the
commodity which slows digestion, the patient will tend to live a
miserable existence by being constantly hungry.
However, until our knowledge of cause and effect is complete,
it would be unwise to delay the introduction of preventive
measures such as weight reduction, restriction of the intake of
animal fat, control of smoking, introduction of regular exercise
and, most important, the dissemination of reliable information by
health education officers.
Diseases of the Respiratory System.—Altogether there
were 117 deaths from these diseases during the year, pneumonia
(all forms) accounting for 50 and bronchitis for 55. While the
total shows a decrease of 25 from that of the previous year,
deaths from pneumonia fell by 14 and bronchitis by 17.
Of the total deaths recorded, 7 were children under one year
of age and 92 were in respect of persons 65 years and over.
Greenwich rates for pneumonia and bronchitis were 0.60 and
0.66 respectively, which compare favourably with those returned
for London, namely, 0.71 and 0.67. The corresponding rates for
England and Wales were 0.63 and 0.60.
Chronic bronchitis, known abroad as the "English" disease,
was responsible for a loss of over 30 million working days during
the year compared with only one million from industrial disputes.
Largely a preventable disease it has been the cause of 30,000 or
more deaths annually for over a quarter of a century. The
B.M.A. considers that there are 3 main causes, atmospheric pollution,
pollution at work and cigarette smoking and they state
that smokers develop the disease some 20 years earlier than nonsmokers.
Statistics concerning the incapacity resulting from bronchitis
are very sketchy but there is evidence to suggest that, locally, it is