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38
Incidence of Disease.
Exact information is not available to measure the standard of fitness
or of invalidity of a community. The few statistics at hand are those
of communicable diseases. Records such as those of a hospital show
what illnesses or abnormalities take the patients attending that
particular hospital either as in-patients or out-patients, and, especially
where such a hospital serves a limited community so that the population
in general can attend only there, the figures are useful for comparing one
year with another. Even those figures though serve only a comparative
purpose, and are not a measure of the illness of the community. Even
were records compiled from all the agencies dealing with invalids, including
hospital in-patients and out-patients and all the general medical
practitioners, all that would be listed would be the number of people
who attended for treatment for different conditions. The records would
not indicate, for instance, the total number of persons whose stomachs
were ulcerated but only those who attended for treatment for the
condition ; the person suffering from a gastric ulcer though is burdened
with something other than and in addition to the ulcer. This aspect
possibly had something to do with the disappearance of illness at the
outbreak of the war, perhaps the most striking occurrence in regard to
health during the war years, unless pride of place in this respect goes to
that astounding freedom from all those pestilences spread by droplet
infection which by all the laws of probability and of hygiene should
have decimated the population living in the shocking conditions in the
shelters during the earlier periods of enemy raiding. Our freedom from
plagues has coincided with the period when perhaps the general community
has benefited most from and enjoyed the soundest physiological
nutritional standards. While some factors, e.g., vitamin A have attributed
to them anti-infective powers, and while malnutrition is accepted
as an aetiological factor in the onset of tuberculous disease, in general
a patient's sound nutritional state has been thought to be of greater
help in aiding him to overcome rather than to resist an infection, so
that these benefits were not expected to follow good feeding. The
cause may of course be assumed to be a fortuitous and most fortunate
waning of the virulence of organisms, the opposite state of the enhanced
virulence of the organism responsible for the influenzal pandemics
which were the sequel to the last world war. If, on the other hand,
as an explanation recourse must be had to metaphysical conditions,
particularly the mental state of the population who were the prospective
sufferers from the invasions of the organisms, it will be of interest to note
whether, quite apart from the introduction of some exotics, the health
of the population as determined by the prevalence of communicable
diseases is to deteriorate.
Notifiable Diseases: The incidence of those diseases considered
to be spread by droplet infection has been most variable. The 500
cases of scarlet fever in 1938 were followed by much the same incidence
for the earlier part of 1939 when there were 90 cases in the first quarter
and 142 in the second. The third quarter started with a somewhat
lighter incidence, but during its last eight weeks on no occasion were