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64
Some mental instability is precipitated by institutional care which
many old people view with trepidation. In their minds it represents
their last move, it robs them of their independence, it makes all
decisions for them and usurps their responsibility and they have
nothing to live for and so lapse into apathy. Fortunately, this
attitude and type of welfare home is rapidly changing.
Co-ordinated local authority services have a vital part to play in
relieving mental illness which has so many facets and which
demands so much from so many professions and skills in its
prevention.
Respiratory Infections
Very naturally, the "glamour" of heart, kidney and liver transplants
have taken the "limelight" in medicine but this must not
blind us to the more mundane but equally important problems such
as respiratory disease. Patients who may benefit from such radical
surgery are limited and the number small in comparison with those
who would obtain a fuller life if respiratory disease could be substantially
reduced.
Examples of national mortality arising from chest diseases during
the current year are,
Lung Cancer 28,252 deaths
Pneumonia 32,657 „
Bronchitis 27,811 „
Respiratory Tuberculosis 1,798
Other Respiratory Diseases 5,016
and the total shows that almost one in every five deaths (18%)
throughout the country resulted from respiratory trouble. The
comparable figure for Greenwich, viz. 21.4% is even less favourable.
Moreover, mortality figures in themselves are less than half
the picture for they give not the slightest indication of the disability
occasioned by these respiratory diseases.
The tragedy of the situation is that the bulk of these deaths and
the permanent disability so often preceding them are the direct or
indirect results of cigarette smoking, the elimination of which could
reduce the enormous physical and financial burden being carried
by the country's medical and welfare services. Assimilation into
the circulatory system of oxygen, that indispensable commodity
without which life is impossible, can be effected only by means of
the lungs and yet the defiling of these organs on such a large scale
merely demonstrates a human capacity for self-immolation.
Bronchitis, an almost inevitable concomitant of tobacco smoking,
alone is responsible for the loss of over 30 million working days per
year and is the commonest reason for seeking medical advice, there