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and that this is one of the reasons why Coronary disease affects women less often than men It
is probably true to say that housework requires more physical exertion than office work; others
have noted that the disease is more common in the bulkier members of the community and have
suggested, therefore, that the disease is more common in those who overeat, Others say that
it is what is eaten that is important, Adletrich in fat, they say, is dangerous. Experimental
work on rats suggests that too high a proportion of certain phosphates in the diet will cause
damage to the heart and that if disease of the Coronary arteries is already present before the
phosphate intake reaches a dangerous level, the later high level of phosphates will considerably
increase the amount of Coronary disease and damage.
In experimental animals exceedingly large doses of Adrenalin will produce heart damage
very similar to that produced by narrowing or blocking of the Coronary arteries. If the animal
is worked into a state of panic, the same kind of damage to the heart may be produced. If the
same holds good of the human,, the heart damage that appears to be precipitated by sudden physical
or mental stress, (the classic case is that of the previously healthy soldier who dies in
battle from sudden heart failure), is due to an excessive outpouring of Andrenalin into the
blood stream. The work on experimental animals suggests that this is a direct effect on the
heart muscle rather than an indirect effect as a result of excessive speeding of the heart rate,
and heightening of the blood pressure It is not, therefore, surprising that there is less of
this form of heart disease in the country, where life is quieter, than in the busy and traffic
laden town. There is as yet no firm proof that lack of sleep, hurried meals, and worry have
adverse effect on the heart, but since they are undoubtedly bad for patients suffering from
Coronary Thrombosis, they may well play a part in causing it. The disease is more common in
smokers than in non-smokers but tobacco products, so far, have not been shown to cause Coronary
Thrombosis in animals, Chimney smoke does not seem to play a part in causing the disease, but
it tends indirectly to shorten the life of the sufferer from Angina by damaging the Lungs and
so increasing the load on the heart. Though the disease is not infectious, it may be that the
time has now come when it should be notifiable. Investigation of non- fatal cases over a number
of years throughout the country would probably show how it is usually caused and how it could
be avoided. Though the prevention of 60 premature deaths would only reduce the crude death rate
by .62 (to 9.16), the postponement of bereavement in 60 families is well worthwhile from every
point of view.
BRONCHITIS AND PNEUMONIA
Not all Pneumonia follows Bronchitis but the two diseases are frequently associated and
the Registrar General, therefore, groups them together in his table of premature mortality
Table IV shows this group to be as important a cause of premature death in men as Coronary
disease and to be the most important cause of premature death in women.
In Edmonton the picture is similar to that in the country as a whole. Male deaths exceed
female deaths (Table V). The diseases are more common very early in life and fairly late in
life.
Bronchitis is a very common cause of death in England and Wales as a whole and the Edmonton
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