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Another diminishing group has the efficiency of the heart decreased
as a result of infection, but the chief cause, rheumatic fever,
has rapidly decreased in incidence during the last 30 years for some
obscure reason. A substantial proportion of premature adult
deaths from heart failure is due to damage originally due to this
infection.
By contrast, included in this group are those residents who
have died virtually of old age, their hearts or arteries having
eventually worn out. It is impossible to tell exactly from the
brief death certificates which of the deaths can be attributed to
old age and which to the larger group in which the primary cause
of death appears to have been the same, except that it may be
thought to have occurred prematurely. Some satisfaction can be
gained if it is found that in general the average age at which death
occurs is getting higher.
During 1956 we find that 78% of the ordinary residents whose
deaths were allocated to this group were over 65 years of age,
compared with 80% in 1955 and an average of 79% in the previous
five years, i.e. not much change has occurred. However,
56% of the group were over 75 years compared with 52% in 1955
and this is a welcome improvement.
What can be done to diminish the appreciable proportion who
die before 65 years of age? Unfortunately, the fundamental
cause of clotting in the blood vessels, which underlies thrombosis,
and of fracture of the vessels, which causes mainly cerebral
haemorrhage, are not known. Evidence suggests on the one hand
mistakes in diet, bearing in mind the occupation of the individual,
and on the other, ways of life conducive to a permanent raising
of the blood pressure. Of the first it may be said that in general
the quantity of food, and especially the fats and carbohydrates,
should be decreased the more sedentary the occupation. Of the
second, the more even the tenor of life the better. Chief among the
causes of raised blood pressure are drugs, including alchohol and
tobacco, emotional stresses, including anger, fear and anxiety, and
possibly over-eating and constipation. The cultivation of a cheerful,
optimistic and philosophical way of life with ample mental
and physical relaxation is to be commended.
CANCER.
The cancer death rate among ordinary local residents was
1.79(i.e. deaths in each 1,000 of the population) compared with
1.77 in 1955 and 1.87 in the previous 5 years. The latter is.
however, about double what it was 30 years ago. In part, of
course, this increase is due to the increase in the average age of the
population, cancer being chiefly a disease of the more elderly;
partly it may be due to better diagnosis, but it is generally believed
that to some extent a true increase in prevalence has occurred,
especially in lung cancer in men.
Cancer is esentially the misbehaviour of certain cells of the
body which, without notice, multiply in numbers causing a 'new
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