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115
Expectations from Prevention,
It is sad to think that at present the policy is one of " Drift."
Hitherto we have treated the acute rheumatic heart, and we have
patched up the chronic heart that is so often the result of rheumatism.
We have treated the actual heart condition when we have met with it
in the wards or in private practice. We must now face the preventive
side with vigour. We must hark back upon the causes, we must control
the active element of the disease, the germ, the poison, and destroy the
conditions which make its growth and propagation possible. Prevention
has not been given the attention it deserves.
Dr. Poynton's lecture calls upon the hygienist to play an active
role. Such apparently simple matters as the care of the teeth, the
proper clothing and footgear of children, the house, wind and weather
tight, should play their part as factors in the campaign against
rheumatism.
A heavy responsibility rests upon all local authorities through their
Maternity and Child Welfare and School Medical Inspection Centres,
to educate parents on these matters. Research is called for. Dr.
Poynton says it is a disease of the "hospital class" of children rather
than the better circumstanced. Good housing, more space, more and
better food and clothing, more education, these are required, though not
everything. It is desirable that all cases of rheumatic fever (but not
simply rheumatism) should be made notifiable, so that complete records
could be made of the whole history, circumstances, etc., by the Medical
Officer of Health. Through the Ministry of Health, such records,
together with those of the research laboratory, and clinical workers,
should be pieced together. Rheumatic fever is ignored because its
damaging results are not immediate and clamant, and öbecause,
apparently th evirus is of low degree of infectivity.
There is room for a Departmental Committee to enquire.
SOME REFLECTIONS ON CANCER.
Preface by Sir Thomas Oliver, M.D., F.R.C.P., etc.,
Professor of Medicine, University of Durham; Consulting I'hysician, Royal
Infirmary, Newcastle-on-Tyne. Author of " Industrial Diseases," etc.
The ravages of cancer have certainly brought home to the public
the urgent necessity for a careful enquiry into the cause or causes of
the disease. Before we can treat disease we must know something of
its causation. That repeated irritation is capable of inducing the