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39
ledge with regard to the etiology and incidence of cancer, and set out for the consideration
of health authorities some suggestions which might be useful in efforts
to deal with the disease.
These suggestions included the following:—
(i.) Improving the local facilities for clinical consultation and for pathological
examinations.
(ii.) Improving the local facilities for cancer treatment (operative, or
provision of X-ray and radium apparatus) and considering the adequacy of
arrangements for this purpose at hospitals, local institutions, etc., which serve
the area.
(iii.) Improving facilities for transport of patients.
(iv.) Arranging locally for post-graduate demonstrations, lectures, or
courses on cancer for medical men practising in the area.
(v.) Arranging locally for the education of the public by means of public
notices, advertisements, broadcast leaflets, lectures, cinemas, etc.
With regard to the advice given under (v.) the memorandum pointed out that
much caution is obviously needed to avoid over-statement, the making of promises
which are not warranted by evidence, or the production of needless and mischievous
apprehension of cancer.
It is added that it is not contemplated or suggested that there should be
established a public cancer service, analogous to the services for tuberculosis or
venereal diseases, but that on the other hand public health authorities, etc., should
not feel discouraged from individual action within their competence from assisting
in securing better facilities for diagnosis or more effective treatment of cancer.
London is in a specially advantageous position in comparison with other parts
of the country, as well in regard to treatment as to the other suggestions to local
authorities referred to above.
It has been observed that in many towns and countries a low phthisis mortality
is associated with a high cancer death-rate and vice-versa. In London a small
negative correlation is found between the crude cancer death-rate and that of phthisis
in the metropolitan boroughs, but when the rates, corrected for differences in the age
—and sex—constitution of the various populations, are compared there is a small
positive correlation: there does not, therefore, appear to be any actual inverse
relation shin in the incidence of cancer and phthisis mortality.
Publicity was given during the spring of 1923 to a number of cases of skin
disease due to the wearing of ladies' furs. The occurrence of such cases was observed
by Dr. Veitch Clark, the medical officer of health of Manchester, as early as January
1923. He inquired whether there was any evidence of similar skin conditions in
London, and he was informed that no such cases had up to that time come to light
In March, however, various notices on the subject appeared in the medical and lay
press, and as a result of enquiries made it was found that quite a considerable number
of cases of " fur dermatitis " had been dealt with in the general hospitals in London
and the provinces.
Skin disease
due to
wearing furs.
It was at first popularly believed that the condition was associated with some
disease of the animal from which the fur was derived and later it was thought that
some compound of arsenic used in the dye, with which the fur was dressed, acted as
the irritating agent. A sample from one of the furs implicated however was examined
in the Council's chemical laboratory and the report of the chemist was as follows:—
A large amount of dye soluble in alcohol was found. The matter soluble
in ether was practically all oil. A hydrochloric acid extract yielded no evidence
of metals. The ether extract and alcohol extract, both tested on the skin for
over 24 hours, caused no irritation. The brown dye extracted had properties
similar to phenylene-brown. There was slight evidence of diamines in the acid
extract, and it appears probable that the toxic effect on the skin is due to small
quantities of volatile dimethyl-paraphenylene-diamine or an allied substance