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is true; but it does not seem to be sufficiently appreciated that a
tremendous amount of valuable work can be done " in the field " by
all medical men and women. It is true that there have been instances
of startling discoveries made by the intervention of pure chance in
the work of one who had the genius to grasp the full implications of
what had occurred ; Penicillin was such a discovery. But, in the
main, research is a long process and the torch must be passed from
hand to hand. Accumulation of a large mass of observations,
records and evidence is essential, and in this collection of evidence
the medical practitioner can take a large part. Patient observation,
enquiry and recording of facts may in time supply the very evidence
which is missing from other investigations. It is to be hoped that the
Medical Services of the future will allow all workers, whether
independent practitioners or men and women in the National or
Local Government Services, time and opportunity to contribute, as
they will certainly be well able to do, to the task of elucidating the
origins of many of the conditions about which we are in ignorance.
Turning to the last five-year period in the table, we find that
excluding Kidney Disease—which remained stationary—and
Violence which as noted above declined sharply, every group of
diseases shows an increase in mortality.
I have already remarked on the increase in mortality from
Cancer and Tuberculosis.
The increased mortality from Pneumonia and Respiratory
Diseases generally occurred mainly in 1940 and 1941, and the winter
air-raids which compelled so many people of all ages to spend night
after night in out-door shelters no doubt contributed to this result.
War-time diet and war-time conditions and anxieties may have
influenced the mortality from diseases of the Digestive System.
The increase in the number of deaths from other infectious
diseases was entirely due to outbreaks of Influenza in 1940; and 1943.
DIPHTHERIA IN BECKENHAM OVER A PERIOD OF FIFTY
YEARS.
The infectious disease records of Beckenham in the possession
of the Public Health Department go back to 1895. The record of
the incidence and mortality from Diphtheria over this period will
no doubt be of interest.
Five-year
period
Attack rate per
1,000 population
Death rate per
1,000 population
Case Mortality rate
Deaths per 100
cases
1895-1899 1.24 0.19 15.8
1900-1904 1.27 0.17 13.9
1905-1909 1.92 0.14 7.4
1910-1914 2.32 0.15 6.6
1915-1919 0.93 0.03 3.4
1920-1924 0.88 0.07 8.2
1925-1929 1.07 0.09 8.3
1930-1934 0.40 0.008 2.0
1935-1939 0.22 0.014 6.6
1940-1944 0.24 0.017 7.1
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