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Exaggerated Responses.
The level of blood pressure may rise and fall in response to physiological
stresses, strains and necessities. It may also rise and fall if there is any disease
within the body which requires a temporary rise in blood pressure to supply
blood to an affected part. It would seem when this occurs in some individuals
there is a secondary response by the tiny arteries of the body which contract
to keep the blood pressure high; but when the time comes for the pressure to be
reduced again, the mechanism for the relaxation of the arteries seems to fail;
so that the blood pressure remains permanently at a higher level than before
and at a level higher than it need be. The small arteries seem to exaggerate
the requirements of nature. Thus the mechanism which sends up the blood
pressure to counteract or cure some disease itself results in damage to the tissue
of the kidneys. When this occurs a vicious circle is set up, the kidney lesions
themselves producing a higher blood pressure, the kidney disease getting worse,
the blood pressure going higher still and so on. This is the dangerous and
distressing fact about high blood pressure, namely, that a physiological response
becomes over-exaggerated.
Prevention.
Year by year our death returns show that fatalities due to high blood
pressure, especially stroke, are, together with cancer, becoming a commonest
form of terminating this life. There is some evidence to show that excessive
intake of fat produces some chemical which causes the blood pressure to rise,
and that once the rise has started it is very difficult to reverse it. This may
be only one of many causes, but in the meantime a preventive measure would
be for people to avoid getting excessively fat.
THE WAR OF THE VIRUSES
Atypical Infections.
It is possible that we acquire immunity to many more virus infections
than was once thought to be the case. I recently saw some children with spots
on the skin very like those seen in chickenpox. Most of the children had been
diagnosed as cases of chickenpox, and yet on close examination of the lesions I
thought they were not just exactly typical of classical chickenpox as described
in the books. There was something different about the shape and the grouping
of the spots and the amount of crusting. The condition was very infectious
and had spread through a community of children, in which practically all had
been infected. Young children often have little spells of fever with vague
symptoms, the whole illness passing off within, say, 12 to 24 hours; a doctor
is never called in and the illness is never diagnosed.
Epidemic Nausea.
In January, 1952, there was an outbreak of epidemic nausea, or winter
vomiting. Although this condition is not new, I have not seen it in this
borough in such proportions as it appeared to be that winter. The practitioners
were good enough to notify it voluntarily and we investigated about 60 cases.
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