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plaint but it is evident that the majority are concerned only with
the milder forms. Nevertheless, almost 1 million females and ½
million males are estimated to be suffering from the serious and
potentially crippling forms of rheumatoid arthritis, the most feared
form, whose pathogenesis remains obscure.
All rheumatic conditions rise steadily with age from 29% in
males and 25% in females between the ages of 15 and 24 years
to a peak of 76% and 87% respectively between the ages of 55
and 64 years. In the latter group, some 47% of men and 40% of
women give a history of incapacity due to rheumatism of which
20% state they have lost at least 3 months' work from this particular
cause.
With osteoarthritis it is estimated that the incidence ranges from
20% in all men and 30% in all women over the age of 15 years
but radiological evidence indicates that, over the age of 65 few
people, if any, are free from intervertebral disc degeneration.
It would seem that the extremely complex research, patiently
carried out over recent years, is about to be rewarded. The probable
causes have been reduced to three, namely, immune response,
enzyme destruction and changes brought about by micro-organism
activity.
Improvement in the treatment and rehabilitation of the rheumatic
groups is of great concern to local authorities for it becomes their
responsibility to sustain individuals and their families when they
become registered as disabled. It should be the authorities' aim,
whenever possible, to ensure that after-care is such as to improve
the functional state and so maintain morale which is so essential
in such cases.
Rheumatic induced immobility in the elderly often results in
a regimen of "tea and bread-and-butter". It falls to the vigilance
of the geriatric visitor, in her preventive role, to assess the situation
and, accordingly, to arrange for supportive services (including the
use of nursing and medical aids) to avoid the development of avitaminosis
and anaemia arising from such a deficient diet.
It is pertinent to record that out of a total of 1,530 persons
registered as physically handicapped in Greenwich in 1970, 468
or 30% are disabled due to the effects of rheumatism.
Venereal Diseases
The term "venereal" is given to a group of diseases imparted
during sexual intercourse of which, in England, syphilis and
gonorrhoea are the most important. In addition to pediculosis
pubis, sexually transmitted diseases include the less well known