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excessive drinking as that which goes beyond the ordinary compliance
with social drinking customs of the whole community concerned
and an alcoholic as that excessive drinker whose dependence on
alcohol has attained such a degree that it shows a noticeable mental
disturbance or an interference with his bodily or mental health, his
inter-personal relations and his smooth social and economic functioning
or who shows signs of such development.
According to the Jellinek formula, it has been estimated that
there are about 300,000 alcoholics in England and Wales of which
some 70,000 are chronic cases but these figures could be gross underestimations
for excessive drinking is considered a social stigma to be
hidden at all costs.
Alcoholism appears to affect all socio-economic classes although
more patients from the higher social groups seek treatment, and
males are more prone to it than females, the ratio being in the order
of 2:1.
These generalisations indicate the paucity of our knowledge in
this sphere and merely serve to emphasise the need for more research
to ensure that errors of theory and practice are not perpetuated.
What can be said is that restrictive legislation of the kind introduced
in America failed and that concentration upon the 'medical' aspects
of the problem is more likely to be successful, Meanwhile education
will continue to be the first line of defence.
Heart Disease
Following the national trend, diseases of the heart were responsible
for almost 32% of all deaths in the Borough during 1966 and,
when taken in conjunction with circulatory disease, the percentage
rises to over 35. Besides being the reason for a prodigious loss of
man-working capacity in the United Kingdom amounting, it is
estimated, to some 12 million week days per year, cardiovascular and
atherosclerotic diseases, as a group, account for more deaths than
any other single cause and, therefore, constitute the greatest possible
challenge to preventive medicine.
In particular, the middle-aged man is enjoying unprecedented
prosperity and affluence but, today, his health falls short of pre-war
standards, primarily as a result of persistently rising death and
disability rates of his heart conditions with special emphasis on
coronary disease.
Conclusions from the M.R.C's social medicine unit's investigation
into middle-aged men and their jobs supports the view that
physically active men have a lower incidence of coronaries than
those less actively employed but, a further study indicated that it was
not just simply a question of the job. There was evidence suggesting
that there may be a common genetic factor which could have a