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20
It must be recollected that Health Visitors, Midwives and
Maternity Nurses come intimately into contact with women at an
age before Cancer is peculiarly liable to attack the body.
Whatever action is taken, much caution is needed in announcements
to the public on Cancer in order to avoid over-statement,
the making of promises which are not warranted by evidence or
the production of needless and mischievous apprehensions of
Cancer.
Certain common sense rules of prophylaxis could, without any
danger, be emphasised.
The liability of Cancer to follow chronic irritation of so many
different types is remarkable, and leads to the supposition that
beneath them all there lies some common factor—as yet unrecognised—which
is fundamental to the passage of a chronic inflammatory
and non-cancerous condition into one that is definitely
cancerous.
This consideration indicates that there are at least some
provocative causes of Cancer which can be guarded against. Since
Cancer occurs more commonly in certain sites, it is prudent to notice
and remove causes for chronic irritation in those sites.
In this category, for example, come the removal of rough stumps
of teeth, or replacement of badly-fitting dentures; a change of habit,
if smoking is found to produce soreness on the same spot of the lip
or tongue; an alteration of clothing which causes irritation of
particular regions of the body—for example the breast; the
avoidance of constipation and like matters.
Heart Disease.—In the table giving the causes of, and ages at,
death, it will be noticed that organic heart disease has become one
of the most important causes of death. Last year in this district 60
deaths were due to organic heart disease; in 1922, the figure was 78.
These figures do not include rheumatic fever, diseases of arteries,
embolism and chorea, in which directly or indirectly heart disease
is the cause of death.
Mortality tables place diseases of the heart in an unenviable
position at the head of the list of causes of death.
From an economic point of view, heart disease is the most
important cause of death in the mortality tables. Owing to the
incidence in different age periods the economic wastage in heart
disease is greater than in most other diseases, particularly when
one takes into account the years of invalidism that antedate the
fatal issue in most cases of heart disease.
With a causal condition that in the majority of cases is
frankly infective something should be possible to mitigate the extent
of these diseases. In the School Report attention has been drawn