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forms of treatment. In addition numerous cases of pneumonia, bronchitis, emphysema,
heart conditions, cardiac failure and many other conditions are dealt with
including hospital treatment by physicians who see the patient both in the Clinic and
in hospital.
The tuberculosis situation is improving steadily. The total number of new cases
discovered during the year was 86 compared to 120 in 1964 and to 200 or 300 only a
few years ago. There is no waiting list for hospital and all the machinery for the
discovery and prevention of the disease is kept at full pressure. Over 3,000 contacts
were examined, 254 children inoculated with B.C.G. and 4,588 home visits made by
health visitors.
Chest Clinic, Deptford
I am indebted to Dr. J. P. V. Rigby for the following report concerning the Chest
Clinic at Harton Street of which he is the Chest Physician.
The Deptford Chest Clinic remained extremely busy during 1965. Over 1500 new
patients were sent to me for investigation of chest symptoms by family doctors or
other physicians, thus averaging 30 each week throughout the year, out of a total
attendance of nearly 6,000 patients. There were in fact, 73 new cases of pulmonary
tuberculosis diagnosed, excluding those transferred into North Lewisham from
elsewhere. I saw 26 cases of lung cancer, some of whom had a lung successfully
removed, and many more new cases of disabling bronchitis, often with cardiac complications.
Lung cancer continues to be a problem both locally and nationally. According to
the Registrar General this dread disease will reach an expected maximum in the
1970's, some 30 years or more after the peak of wartime and post-war cigarette
smoking. There is however, some cheering evidence to suggest that cessation of
smoking can halt the cancer tendency in some of those who are smoking heavily
at present. It may be that lining cells turning cancerous in the bronchial tubes of the
lungs cannot develop fully without continued whiffs of the tars in tobacco smoke.
We now have hope that these abnormal cells can even be replaced by normal growing
tissue again once the irritant smoke has gone, provided that the process has not
gone too far.
Though perhaps harder to prove, it seems likely that other factors like atmospheric
pollution may also accelerate changes towards cancer just as it is known to worsen
bronchitis. Anyone who leaves a car, or cleans a window ledge in local parts where
smoke is still not controlled, will find a layer of dust to remove next day. This dust
contains an acid substance called sulphur dioxide which when dissolved in water
vapour, forms sulphuric acid capable of corroding stonework. Its effect on the
lungs of local bronchitic sufferers can be well imagined. This dust and acid material
arises from certain industrial and domestic chimneys.
Back in 1960, I took part in the Medical Research Council investigation of the
effects of air pollution on bronchitic patients in the London area. The whole study
involved 1,000 patients, who kept diaries and recorded the days when their symptoms
were most severe. It was found that the more severe symptoms coincided with days
when the atmospheric pollution was worst. Adverse weather conditions did not
seem to matter so much. Incidentally, there is a high mortality among advanced
bronchitis despite the most energetic treatment.
Now a word about the vast increase in motor vehicles on the roads of Lewisham
Borough and indeed most urban areas in Britain. They are dangerous in reckless
hands and the noise they make is troublesome, but their exhaust fumes often contain
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