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REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1958 3
definite answer can be given but at least observance of what are
usually known as the rules of health can certainly do no harm and
might quite well do a great deal of good. Regular habits, steady work
within the individual's capacity, reasonable outdoor exercise in
relation to age and fitness, temperance in eating and drinking,
particularly of fatty foods, are all part of the kind of life which most
sensible people would, in any case, wish to lead. Nevertheless,
people who consciously or unconsciously conform to these rules, do
and will become victims of the disease, whereas others who prefer to
ignore them and live for the day may not be affected. Medicine and
public health are not exact sciences and there is a great deal that is
hidden, although the Ancients may have had an inkling of the truth
for we read in the Apocrypha "A cheerful and good heart will have a
care for his meat and diet".
The number of notifications of tuberculosis at 589 was 40 above
the previous year, this increase being in part due to the transfer of
cases from other boroughs of London into Wandsworth consequent
upon the extensive new housing construction which has been going
on in the Borough. A better idea of what is happening in the field
of chest diseases can be obtained by considering deaths from
tuberculosis and other chest diseases, particularly lung cancer and
bronchitis. In 1958, there were 43 deaths from pulmonary tuberculosis
in Wandsworth and the corresponding figure in 1950 was 136.
In the case of lung cancer, there were 264 deaths in 1958 compared
with 139 in 1950 and in the case of bronchitis there were 305 deaths
in 1958 compared with 259 in 1950. In other words, while there has
been quite an astounding reduction in the number of deaths from
tuberculosis in the eight years from 1950, there has been an equally
marked increase in the number of deaths from lung cancer and to a
lesser extent from chronic bronchitis. It is clear that while tuberculosis
still remains a problem, it is proportionately much less so,
whereas lung cancer and to a lesser extent bronchitis, have become
more of a problem.
In spite of advances which have been made in the diagnosis and
treatment of tuberculosis, there are no grounds for complacency and
it is not likely that we shall see the end of this disease in the foreseeable
future although we may have reached the beginning of the
end. As regards lung cancer and chronic bronchitis, the immediate
outlook is not hopeful. Associated as they are in different measure
with heavy cigarette smoking and atmospheric pollution, social and
environmental factors not capable of quick and easy change, the
expectation is that in the years immediately ahead there will be
more deaths from these diseases. No doubt if and when heavy
cigarette smoking becomes less ingrained as a social habit, there
will be fewer cases of lung cancer and similarly as clean air campaigns
in our large towns and cities get under way, then the outlook
for chronic bronchitis will be improved. In the immediate and
near term, the greatest hope lies in early diagnosis of lung cancer