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We have had a country-wide epidemic this summer, not so great asi
1947, but still fairly widespread. Twickenham has been fortunate in havin
only 9 cases, of which 7 had paralysis and 2 no paralysis. Two of the paralyti
patients died. The public, justifiably, have a widespread fear of this illness
although it receives far more publicity than tuberculosis, which is much moi
frequent and serious.
CANCER AND SMOKING
Since about 1920, the national death statistics have shown more and mor
cases of people dying from cancer of the lung. When allowance is made fo
the more ready use of X-rays and increased accuracy in diagnosis, there is m
doubt that the increase in deaths from lung cancer is real. This last year o
two there have been a number of reports which show that cancer of the lung
has in part something to do with smoking.
An investigation carried out in 1950 by Dr. Doll and Professor Bradfori
Hill,1 showed that more people died of cancer of the lung who were heavt
smokers than those who were not; and that the probability of dying of cancel
of the lung was roughly related to the number of cigarettes or amount of pipe
tobacco smoked. A person who smoked 20 or 30 cigarettes a day was mori
likely to get cancer of the lung than a person who smoked two or three only
The method of carrying out the enquiry was to question those people in hospitals
with known cancer of the lung about their smoking habits, and then to question
other people of equal age and sex, but without cancer of the lung, and then to
compare the answers of the groups. It is not of course claimed that smoking
is the sole cause of cancer of the lung, but it may be a contributory factor,
That there are other factors is shown by Dr. Stocks,2 who has reported that
the risk of dying from cancer of the lung in any area is closely related to the
amount of smoke which is poured into the atmosphere and which may contain
sulphur dioxide, arsenic and benzpyrene. The greatest risk occurs in the
large densely populated towns like London, Manchester and Liverpool. The
effect of the prevailing wind is to increase the risk of lung cancer in those
districts which receive the smoke blown towards them, as in Finsbury, Shoreditch,
Bethnal Green, Stepney, and Bermondsey in the London area.
In the present state of our knowledge all we can say is that when certain
products of combustion are inhaled over long periods, they do something to
the lung tissue which makes it more susceptible to an attack of cancer. We
do not know which products of combustion do it, but they are the things
which come from burning coal, and presumably burning tobacco. It may be
that these products have to be associated with something else; it could possibly
be a virus, but that we do not know. At any rate it would seem a useful
preventive measure to limit the amount of smoke inhaled, whether it comes
from tobacco or from our chimneys.
1 Doll, R., Hill, A. B. (1950), Brit. Med. J., 2, 739, and (1952), ibid2, 1271.
2 Stocks, P. (1953), Brit. Med. J., 2, 847.
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