816

reaches its peak during the period 40-60. Females areonly slightly less heavily infected than are males ofthe same ages. As regards race susceptibility, theChinese have practically the same infection-rate astheir Siamese neighbours ; the Indians maintain aslightly higher rate. Of the total population examinedno less than 75-8 per cent. are infected with someintestinal parasite. and next to the hookworm, Ascarislzsmbrzcoides is the most important. Very considerableattention is being given by the survey units to thequestion of health propaganda designed to create

popular interest in public health matters.f

____

DR. KERR’S RETIREMENT.

AT the County Hall on Oct. 1st Dr. James Kerr wasentertained by a largp number of his colleagues pastand present, and handed to him amemento of the high appreciation in which he hasbeen held as research medical officer to the LondonCounty Council. Dr. Kerr entered the service of theLondon School Board as medical officer in 1902.Before that he was in practice in Bradford, where ashonorary surgeon to the Bradford Royal Eye and

Ear BHospital and medical superintendent to the BradfordSchool Board he conducted an active exploration ofthe possibilities of school hygiene, a field hithertountouched, using unorthodox but scientific methods ofinvestigation into such questions as vision-testing,estimation of mental ability, and infectious disease.His work in this direction was recognised by the awardof the Howard Medal of the Royal Statistical Societyfor an essay which contained the first reference tocongenital aphasia in cases of word-blindness andword-deafness among school-children. On this earlywork of Dr. Kerr’s has been erected the vast structureof the school medical service as it stands to-day. Hewas also an active member of the DepartmentalCommittee on Physical Training, and took a prominentpart in organising the International Congress onSchool Hygiene, which was held in London in 1907.During the war Dr. Kerr founded and, until he leftthe service, directed the London Psychological Clinicfor treating patients suffering from shell-shock byre-educative methods. He has been for many yearsa member of the Council of the Illuminating Engineer-ing Society, and was one of the English representatives

_ appointed to the recent International Conference on

14L Standards of Illumination. All which goes to showthat in retiring from the routine of office work Dr.Kerr does not intend to lead a life of leisure. We mayhope that he will embody his unrivalled knowledge ofthe principles of school hygiene in some permanentform. We understand that he has not quite severed hisconnexion with the London County Council, which willstill be able to avail itself of his services in a consulta-tive capacity. ____

PREVENTION OF HEART DISEASE IN

NEW YORK.

AN account of pioneer work carried on in NewYork was given recently at a post-graduate medicalcourse in Dayton, Ohio, by Dr. Haven Emerson,president of the Association for the Prevention andRelief of Heart Disease.1 Dr. Emerson compared thepresent situation with regard to heart disease to theposition which tuberculosis held a few years ago.Organic heart disease is at the present time thefirst of the killing diseases in America. It is not atpresent thought of as " curable, preventable, andcommunicable," yet there are grounds for supposingthat to a certain degree all three of these adjectivesare applicable. A large proportion of cases resultfrom the rheumatic group of infections, while syphilisis responsible for a growing proportion of the organiclesions arising after the age of 30. Forty-eight heartclinics have been established in the city of New York,cases being referred to them by the general hospitals

1 Executive Secretary, Miss M. L. Woughter, 370, SeventhAvenue, New York.

and dispensaries. Dr. Emerson mentioned that inone children’s hospital the amount of " bed time

"

devoted to cardiac cases had been reduced from30 per cent. to a mere 6 per cent. by the opening ofthese special clinics. While the general hospitals arerelieved, the patients have the advantage of after-care very much like that given to the tuberculous,and a certain amount of vocational guidance. Twotrade schools for teaching appropriate crafts tochildren with heart disease have been opened in NewYork. A suggested list of suitable trades for skilledand semi-skilled workers of either sex is publishedby the Association amongst their educational litera-ture. The Association has also been successful inpersuading convalescent homes and summer campsto open their doors to heat cases. These institutionsno longer fear the possible complications of a suddendeath when the heart cases sent to them have beencertified by a specialist in the heart clinic as suitablefor their particular variety of institutional treatment.

THE CANCER CAMPAIGN IN NORWAY.IN the October number of the World’s Health-

the review published by the League of Red CrossSocieties in Paris-an account is given of the cancercampaign in Norway by Dr. F. G. Gade, who is thesecretarv to the Norwegian Committee for CancerResearch, and who is well known in Norway as thegreatest driving force in this campaign. As he pointsout, the isolated and stationary character of thepopulation in the country districts has been exploitedby the Cancer Committee which has induced manydoctors in settled country communities not merelyto notify cancer deaths, but also to undertake a studyof such subjects as heredity, which require a stationarypopulation. It is interesting to note that cancer ofthe uterus is very rare in the isolated country dis-tricts, and that of all the notified cases of cancer ofthe lip 97 per cent. involved the lower lip, and asgreat a proportion as 88 per cent. of all these patientswere males. Nearly all these cases came from distantvalleys among the mountains, or from forest or coast.districts where the clay pipe is still much smoked.It is only since 1919 that the Cancer Committee hassucceeded in getting all medical officers of health togive a special yearly report on deaths from cancerin their districts, the scheme of this report beingframed by the Committee with 30 differe,nt-localisa-tions, more or less on the lines of British cancerstatistics. From 2700 to 3000 deaths from canceroccur in Norway every year. Cancer, which is respon-sible for 7 per cent. of all the deaths, ranks aftertuberculosis and old age as the most common singlecause of death. There are 10’9 deaths from cancerfor every 10,000 living persons in Norway. Thedisease is equally distributed between the sexes, forwhile 51’8 per cent. of the patients are women, itshould be noted that 51’3 per cent. of the totalpopulation is female. From 51 to 52 per cent. of allthe cases of cancer affect the stomach, and 66 percent. are found somewhere in the digestive tract.Cancer of the uterus, ovaries, and breast accounts for12 per cent. of all the deaths. It is doubtful if thegrowing number of notifications means that thefrequency of the disease is increasing, for such factorsas improved methods of diagnosis and the greateraverage longevity of the population may give anerroneous impression in this respect. To facilitateearly diagnosis, arrangements have been made atthe pathological institutes in Christiania and Bergenfor free microscopic examinations of material removedat operation or after death. Several thousand suchexaminations have been made. A large moderncancer hospital is soon to be built near Christiania,and already two and a half million kroner have beencollected for it. It is to be equipped with all themodern means for diagnosis and treatment, and isintended mainly for poor patients suffering frominoperable disease. The Cancer Committee alsoconducts propaganda for the early diagnosis of thedisease.