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In this category', for example, come the removal of rough
stumps of teeth, and alteration of clothing which causes irritation
of particular regions of the body-for example, the breast, the
avoidance of constipation and like matters.
The other difficulty in carrying out curative treatment lies
in the reluctance of patients to seek early medical advice. In any
condition in which cancer is suspected, immediate and decisive
action is necessary. If early advice were sought, the one from whom
this would be sought would be the general practitioner, but the complaint
of the doctor is that the patients do not come to him at a
sufficiently early stage to enable him to apply successful treatment.
Heart Disease.—Organic heart disease occupies the unenviable
position at the head of the list of the causes of death in this country.
Last year in Acton, 86 deaths from heart disease were registered
and in the last five years 359 deaths, or 11 per cent, of the total
deaths occurred from heart disease. The magnitude and importance
of the problem have been overshadowed, partly, no doubt, by the
consideration given to other scourges of the public health, and in
addition from the belief that nothing in the way of preventative
measures was likelv to be of any avail.
The increase in the number of deaths from heart disease in
this district is marked, and even more so than that of deaths from
Cancer. It is doubtful, though, if heart diseases are so much more
prevalent than formerly as the death returns suggest. Some of the
increase is undoubtedly due to changes in method of classification.
Still, though we may admit that part of the increase may be due
to different classification and improved methods of diagnosis,
this does not minimise the importance of heart disease as a factor
in the public health. There is also another aspect of the question.
The economic wastage in heart disease is greater than in most other
diseases, particularly when one takes into account the years of
invalidism that ante-date the fatal issue in most cases of heart
disease. The following outline in Sir George Newman's introduction
to the report of the Ministry of Health in Rheumatic Diseases
suggests not only the need but the lines on which preventive action
may be taken.
One sixth of the industrial invalidity of the country arises from
Rheumatic affections. The annual cost to the Approved Societies
is two million pounds and the work lost to the members equals
three million weeks per year.