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9
graphy Units were of course originally introduced to detect cases of tuberculosis,
but during their visit here they found, as well as 29 new cases of
tuberculosis, 22 cases of cancer of the lung.
Another cause of death that is diminishing is death from accidents
other than those on the road. This has fallen from 31 to 26 and in each
of the last two years only one of these cases was under the age of 15.
Old People
There are two series of statistics which show what an increasing proportion
of our services is devoted to dealing with old people and their
problems. For example the number of registered blind, partially blind and
defective sighted among us has increased yearly; over the last 7 years the
numbers are: 282, 278, 293, 315, 346, 330, 385. The laundry service, which
also deals almost entirely with old people has, in the last four years, that
is since its introduction, more than doubled in the people supplied and the
number of articles laundered. In the first year 30 individuals received
the service, last year 61. In the first year 2,889 articles were laundered,
last year 11,001.
Notification of Disease.
Members of the medical profession, and Medical Officers of Health in
particular, are becoming increasingly aware of the defects of the present
notification system. Much of it is outmoded and there are other conditions
which we feel should be notifiable, which are not now. As an example, it
would be advantageous if during, say, the first five years after the introduction
of a new drug, all reactions towards it were notified and thus a
true picture obtained at an early stage of its disadvantages.
One of the problems with notifications is of course the indifference of
some doctors and the greater interest of others. For instance, in 1956 we
received 161 notifications of dysentery. Of these, 59 had been notified by
one doctor alone. Of the 70 doctors in the town, 40 did not notify any
dysentery at all. This pattern is not exceptional; it occurs year by year.
We realise that diseases such as measles and whooping cough are not
fully notified, largely because mothers do not take the children to the
doctor. Less than three-quarters of the cases of measles that have occurred
in our two day nurseries this year, when children have been excluded
because we knew they had measles, have been notified. Certain other
conditions are notified when the original reason for their notification has
practically disappeared. I have before referred to the notification of puerperal
pyrexia, which was originally introduced to control infection of the
genital tract, but now this fever is more likely to be due to other conditions,
such as kidney infection.
Ophthalmia neonatorum, many years ago, was somewhat of a scourge,
due to gonococcal infection. It does appear that the notification of ophthalmia
neonatorum is now increasing, certainly in Ilford, even if not nationally.
It is almost certainly the case that this infection is now due to the
staphylococcus which is largely insensitive to penicillin and probably spread
from hospitals. The condition is very mild and usually clears up in a
few days even without any treatment.
In this town, acute rheumatism in children under 16 has been a
notifiable disease since 1935. In that year there were 49 notifications.
Last year there were only 8. Acute rheumatism is playing a very much
smaller part in the cause of heart disease in the population. A clinic was
started in 1933 by the Borough Council and last year was transferred to
the Paediatrician at King George Hospital on the resignation of Dr. Playfair,
who has conducted this clinic for 21 years. It now deals mainly with
congenital heart conditions, so has changed completely from its original
conception.