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tions which encourage disease. This is an obvious truism, with
which no-one will disagree. When one appreciates, however, that
much of this problem will always be bound up with housing,
travelling to business under conditions which should in theory
decimate the population, and other related problems, and when
one appreciates how little a local authority can do at the present
juncture, the futility of vague impracticable statements can only
be deplored.
The housing position in Southgate although, as the Council
will be aware, not what we desire, is apparently not so serious as
in nearby districts. That, at all events, is the opinion which I have
gathered after consultation with hospitals and chest clinics. It is
also a known fact that the factory situation in Southgate presents
very minor problems, which cannot be said to affect the population
to any appreciable extent. When we come to consider the psychosomatic
type of disease, of which coronary thrombosis and gastric
and duodenal ulcers are probably the most prominent members,
the position is still more involved. We all know that the occurrence
of psycho-somatic diseases, very often extremely serious, is
closely linked with the stress and strain of modern life. Here again,
it could scarcely be said that residence in an area such as Southgate
adds to this strain, unless the trying conditions entailed by
travelling to and from London each day can be regarded as a
significant factor.
We must therefore continue to review the whole field of
epidemiology from time to time, so far as Southgate is concerned,
with a view to taking such action as is possible to eliminate or at
least reduce known sources of danger. This will be done so far as
is practicable. But it must once again be stated that, in a Borough
such as Southgate, this is not such a simple problem as many
facile writers and speakers seem to imagine.
Diphtheria
For the fifth year in succession, no case of diphtheria was
notified in the Borough. Almost six years now have elapsed since
a case occurred in Southgate; the last death took place approximately
ten years ago.
I took the opportunity in the Report for 1951 to set out in
some detail the measures which the County Council are taking in
this area in regard to immunisation. The programme is still being
maintained, with certain amendments and additions, suggested by
accumulated knowledge. Thus, children of five years of age entering
our maintained and private schools are now being offered a
reinforcing dose of combined antigen, if this is the type of immunisation
which they received in infancy. We are also contemplating
an alteration in the time at which immunisation is first offered,
since it has now been established that immunisation can be safely
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