MEN AND DISEASE

Greymouth Evening Star, 22 May 1925, Page 2

MEN AND DISEASE

, . TASK FOR SCIENCE. — ■ ' £ - “Many a primitive man, living on a daily handful of some hard grain, unchanged from year to year, . of a kind at which none of us would look for a'moment, has the laugh of us in the long run, with our white bread, our white sugar and what not, and thence the pallid white skin and the plain white grave-clothes which pre-, maturely enfold us,” (writes “Lens,” in the “New Statesman.”). Modern civilised man does won--ders against tropical disease in primitive parts of the earth. The study of infection and infective agents has pointed here to a mosquito, there to s.a flea, elsewhere to a. louse or a tsetse-fly, and in due course disease vanishes and plague-spots become health resorts.' The Panama Canal Zone was, in effect, uninhabitable until such measures as mosquito reduction were put into force, and now its vital statistics are superior to those of representative cities. The chief beneficiaries of these efforts have been and will be the indigenous inhabitants of remote lands, rather than modern civilised man himself, who has done the work. At home he has also notable ■ achievement ,as a i ns *- death. During the present century in this country the -mortality amongst infants has been halved. Comparable reductions have dccurred in North America, New Zealand and elsewhere. The facts are • all the more remarkable since we, know that xvhilst immense improvements were taking place, during the second half of the last tury, in the mortality amongst young adults, from the water-borne diseases especially, infancy shared not at all in this amelioration, but was cut down at the end of the century, as rapidly as sixty years earlier. These gains against death are being steadily maintained and increased, like those of tropical medicine. Like those, these" are for the most part the achievements of civilised men of mature years, whilst the beneficiaries are other than they. , . ' . A noteworthy statistical result of the sudden and imfnense reduction in the mortality of the very young -is, of course, a very great extension of the expectation of life at birth, or of the average duration of life. Compare the prospects of infants born this year with those of 'their predecessors a generation ago, and we find that they will have ten more years of life—or whatever the figure.may be. Unskilled’ commentators on such 1 figures now proceed to tqll us that we are living much longer than our forebears and that the average Londoner of to-day, for instance, may look forward to an extra decade of life. Unfortunately this is nonsense, and the middle-aged are .deplorably deluded if they flatter thereby. The infant hits a much greater chance of life than formerly, and that is well for it; but the morr.tality statistics of* the middle-aged ‘ tell a very different story. We have saved others, but ourselves we are ■’ not saving. The discoveries in tropical medicine, ans the application of knowledge,. mostly far from new, to child hygiene, have transformed those realms of human existence; but the middle aged of modern civilised communities die as fast as ever they ■ did, and perhaps the middle-aged' man more especially. He has got, or at any rate, he has taken, 'almost nothing out ,of modern medicine and hygiene. There are some critics, of the brutal school, who would ,wish to argue that this maintenance of the mortality in later life is the inevitable result of the short-sighted policy whereby we now keep alive the weaklings who. would be much better dead. We siucceed for a time, but at length we must-fail, and the high mortality in middle-age shows how futile it is, by ' our “sentimental humanitarianism” —so much deplored . by the Dean of St. Paul’s, a thinker much in advance of St. Paul, who wrote a chapter on charity long before Darwin liad enlightened us—to attempt to circumvent natural selection. But the historical facts are against this view. Men of forty-five this year were born in 1880, more than twenty years before child hygiene began to take effect, and at a date when natural selection must presumably have had the run of its . teeth. They should he a very fine selected lot, on that assumption; but the death rate amongst them is very high. The truth is that there is a group ' of diseases, needipg a special name and special attention, which we may usefully call, perhaps, the diseases of civilisation, and which are, for the most part, though' not wholly, diseases of excess. They strike at the middle-aged. Most diseases of defect, of insufficient food and light, strike at the young. Tuberculosis and rickets are typical of these, and we. are conquering them. The diseases of luxury, of superabundance, of excess, of civilisation, take their toll in later life. Some of them' are definitely increasing, such as cancer and diabetes. These increase more notably amongst middle-aged men( Of. course when we are dealing with interned disease, requiring some skill in diagnosis, it is a fair question why then their supposed rarity amongst primitive peoples may not be clue simply to thb lack of observation amongst them. To-day, that question may be answered. Modern students highly qualified in diagnosis amt often expert in surgery, have lived and worked for

years amongst these primitive, less (? more) fortunate peoples, and report positively that the characteristic diseases of modern, civilised man are extremely tare amongst them. We are conquering the obvious infections. The diseases now in question are concerned with nutrition and malnutrition, and the epoch-making work of Pasteur and bis followers helps us not at all. Germinal infections occur, no doubt, and put an end to the victim, but they are not the real question, for they take their opportunity only when failure of resistance, due to malnutrition, gives it to them. The diseases in question depend mainly upon the food habits of modern civilised man, and they show themselves chiefly and primarily in his food canal. Dyspepsia, chronic intestinal diseases, appendicitis, diseases of the gall-bladder, and a steadily rising incidence of cancer in and of the food canal, especially amongst men—these are chief diseases in question. To them add diabetes, due to exhaustion and failure of the sugar-digesting apparatus in the pancreas, after long years of overwork due to excessive consumption of starches, and especially of sugar, arteriosclerosis, due to chronic intoxication of the blood,; thence .■•*( ■-i-q n hi

which the poisoned blood is iij con ’ tinual contact; and Bright’s disease due to similar exhaustion and intoxication of those vital elements in the kidneys whose task it is to try to eliminate poisons from the blood, and who often perish poisoned at their task. Let me add that this question is probably even more important in the too-prosperous United States than here. It is engaging the attention of the Life Extension Institute in New York, which tries to persuade the middle-aged to undergo preventive medical examinations at reasonable intervals;’ and of.enlightened insurance compandeb, who tire very seriously concerned '.with the high mortality of the middle-aged. )lt needs more than occasional golf to protect the prosperous middle-aged American against the monstrous excesses of -his diet; and if nowadays he consumes less alcohol, but stuffs himself with sweets, he pierely exchanges the prospect of delirium tremens jfor that of diabetes.