In the course of investigations in Sunningwell parish, Berkshire, certain members of family " H " were found to transmit the dystrophy of mesodermal tissue which is recognized at an early age by' the occurrence of blue sclerotics, laxity of ligaments, and brittle bones, and during adolescence by the onset of deafness (otosclerosis). The mode of heredity is shown in the accompanying diagram, the informants being the widow of No. II 8-since deceased-and No. III 3. When the latter recalled her examination at the Oxford Eye Hospital twentyfour years earlier, contact became possible with the author of a previous paper (Stobie, 1924), describing the syndrome of blue sclerotics, brittle bones, and progressive deafness amongst villagers who have all proved to belong to the " H " kindred. The present communication deals with a recent clinical and social enquiry amongst the " H " family in so far as this affects the prognosis of their familial disorder. The kindred and affinals of family " H " living in-Sunningwell parish number 78. The population of the parish at the last (1937) census was 637.
{"title":"Hereditary Mesodermal Dystrophy","authors":"F. H. Kemp, D. Wilson, W. Fish, W. Stobie","doi":"10.1136/jech.2.2.71","DOIUrl":"https://doi.org/10.1136/jech.2.2.71","url":null,"abstract":"In the course of investigations in Sunningwell parish, Berkshire, certain members of family \" H \" were found to transmit the dystrophy of mesodermal tissue which is recognized at an early age by' the occurrence of blue sclerotics, laxity of ligaments, and brittle bones, and during adolescence by the onset of deafness (otosclerosis). The mode of heredity is shown in the accompanying diagram, the informants being the widow of No. II 8-since deceased-and No. III 3. When the latter recalled her examination at the Oxford Eye Hospital twentyfour years earlier, contact became possible with the author of a previous paper (Stobie, 1924), describing the syndrome of blue sclerotics, brittle bones, and progressive deafness amongst villagers who have all proved to belong to the \" H \" kindred. The present communication deals with a recent clinical and social enquiry amongst the \" H \" family in so far as this affects the prognosis of their familial disorder. The kindred and affinals of family \" H \" living in-Sunningwell parish number 78. The population of the parish at the last (1937) census was 637.","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"2 1","pages":"71 - 73"},"PeriodicalIF":0.0,"publicationDate":"1948-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.2.2.71","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63774943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As was mentioned by Stobie, loc. cit., goitre occurred amongst members of family " H " (Nos. III 7; IV 7, 9, 13; V 7, 15). This is probably due to the fact that they lived isolated lives and used well or spring water in an area known to be low in iodine. Recently village communications have been extended, permitting the purchase of sea-fish, a rich dietary source of iodine, and the water has been changed to the main supply of the nearest large town. New cases of goitre are not occurring in the parish, and a recent school survey did not show a high incidence of adolescent hyperplasia of the thyroid gland. Fluorine is present in the former village water supplies, but the amount (about 0 1 parts per million) is unimportant (Murray and others, 1948).
{"title":"Textbook of Public Health","authors":"Mesodermal Dystrophy","doi":"10.1136/JECH.2.2.73","DOIUrl":"https://doi.org/10.1136/JECH.2.2.73","url":null,"abstract":"As was mentioned by Stobie, loc. cit., goitre occurred amongst members of family \" H \" (Nos. III 7; IV 7, 9, 13; V 7, 15). This is probably due to the fact that they lived isolated lives and used well or spring water in an area known to be low in iodine. Recently village communications have been extended, permitting the purchase of sea-fish, a rich dietary source of iodine, and the water has been changed to the main supply of the nearest large town. New cases of goitre are not occurring in the parish, and a recent school survey did not show a high incidence of adolescent hyperplasia of the thyroid gland. Fluorine is present in the former village water supplies, but the amount (about 0 1 parts per million) is unimportant (Murray and others, 1948).","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"68 1","pages":"73 - 74"},"PeriodicalIF":0.0,"publicationDate":"1948-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85433534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
human and social biology and of human ecology. With the development of social medicine in the universities, and with the expanding recognition in the community of the impossibility of dissociating merely for administrative reasons the medical services and the others which deal with housing, education, and all the rest which promote in one way or another the health of the people, it is probable that in the not too remote future this administrative distinction between the different departments of the central and local authority will gradually be broken down, and with the passing of time the practice of public health in the community will come to mirror the scope and aims of social medicine within the universities. F. A. E. CREw.
{"title":"Tuberculosis in Young Adults: Report on the Prophit Tuberculosis Survey, 1935-44","authors":"F. Crew","doi":"10.1136/JECH.2.2.74-A","DOIUrl":"https://doi.org/10.1136/JECH.2.2.74-A","url":null,"abstract":"human and social biology and of human ecology. With the development of social medicine in the universities, and with the expanding recognition in the community of the impossibility of dissociating merely for administrative reasons the medical services and the others which deal with housing, education, and all the rest which promote in one way or another the health of the people, it is probable that in the not too remote future this administrative distinction between the different departments of the central and local authority will gradually be broken down, and with the passing of time the practice of public health in the community will come to mirror the scope and aims of social medicine within the universities. F. A. E. CREw.","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"2 1","pages":"74 - 75"},"PeriodicalIF":0.0,"publicationDate":"1948-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/JECH.2.2.74-A","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63774583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health Services in England","authors":"F. Crew","doi":"10.1136/JECH.2.2.75-A","DOIUrl":"https://doi.org/10.1136/JECH.2.2.75-A","url":null,"abstract":"","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"2 1","pages":"75 - 75"},"PeriodicalIF":0.0,"publicationDate":"1948-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/JECH.2.2.75-A","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63774674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction The association of endemic dental fluorosis with skeletal changes in the native inhabitants of certain villages in the Madras Presidency was first reported by Shortt and others (1937). Similar bone lesions due to an excess of fluorine in drinking water have been recorded in natives in South Africa (Ockerse, 1941) and in aboriginal tribes in China (Lyth, 1946). The evidence that these changes are caused by fluorine is conclusive, for the radiological appear ances are identical with those found in industrial workers with fluorine (M0ller and Gudjonsson, 1932; Wilkie, 1940) and in the skeletal changes produced experimentally by feeding fluorine to animals (Roholm, 1937). In some cases the clinical features of endemic skeletal fluorosis resemble those seen in the type of ankylosing spondylitis (Marie Strumpell) known in this country as " bamboo spine," which occurs chiefly in young men. Further more, fluorosis tends to affect the spine at a later age and it is common to both sexes. The radiological appearances are totally different (Kemp, 1946). The level of fluorine, about 3 to 4 parts per million (p.p.m.), in the drinking waters associated with bone lesions seen in India and among indigen ous populations in other parts of the world, is often no greater than the amount present in certain English waters, for example at Maldon in Essex, but in this country the social environment is never so unfavourable, and severe skeletal deformity is not seen. As a trace-element, the concentration at which fluorine is effective suggests a catalytic effect and/pr an inhibitor action on certain enzyme systems. Epidemiological studies in the United States combined with standardized grading of dental fluorosis showed less dental caries and more teeth of good structure among people who had used drinking water containing fluorine 0-5 to 1 0 p.p.m. for at least the first eight years of life, that is to say before calcification of the dental enamel is complete (vide Murray and Wilson, 1946). Observations on fluorosis and nutrition in Morocco have made it likely that the effect of fluorine on the development and structure of the dental enamel depends very much on the state of general nutrition (Murray and Wilson, 1948). In certain Oxfordshire villages where severe dental fluorosis is seen amongst the inhabitants, no evidence of developed skeletal fluorosis was found (Kemp and others, 1942), but there was a remarkable incidence of changes in the spines of children of the type described by Scheuremann (1921 and 1936) as kyphosis dorsalis juvenilis! In one school at least a third of the children were affected. The worst cases were seen in the lower social classes, among the younger members of large families, or in children with a history of defective nutrition in the early years. A group of poor Oxford city children examined at this time?the incidence of dental fluorosis in Oxford city as a whole is negligible? showed no such changes. In general the children showi
{"title":"Social and Nutritional Factors in Adolescent Osteochondritis of the Spine","authors":"F. H. Kemp, D. Wilson, E. Emrys‐Roberts","doi":"10.1136/jech.2.2.66","DOIUrl":"https://doi.org/10.1136/jech.2.2.66","url":null,"abstract":"Introduction The association of endemic dental fluorosis with skeletal changes in the native inhabitants of certain villages in the Madras Presidency was first reported by Shortt and others (1937). Similar bone lesions due to an excess of fluorine in drinking water have been recorded in natives in South Africa (Ockerse, 1941) and in aboriginal tribes in China (Lyth, 1946). The evidence that these changes are caused by fluorine is conclusive, for the radiological appear ances are identical with those found in industrial workers with fluorine (M0ller and Gudjonsson, 1932; Wilkie, 1940) and in the skeletal changes produced experimentally by feeding fluorine to animals (Roholm, 1937). In some cases the clinical features of endemic skeletal fluorosis resemble those seen in the type of ankylosing spondylitis (Marie Strumpell) known in this country as \" bamboo spine,\" which occurs chiefly in young men. Further more, fluorosis tends to affect the spine at a later age and it is common to both sexes. The radiological appearances are totally different (Kemp, 1946). The level of fluorine, about 3 to 4 parts per million (p.p.m.), in the drinking waters associated with bone lesions seen in India and among indigen ous populations in other parts of the world, is often no greater than the amount present in certain English waters, for example at Maldon in Essex, but in this country the social environment is never so unfavourable, and severe skeletal deformity is not seen. As a trace-element, the concentration at which fluorine is effective suggests a catalytic effect and/pr an inhibitor action on certain enzyme systems. Epidemiological studies in the United States combined with standardized grading of dental fluorosis showed less dental caries and more teeth of good structure among people who had used drinking water containing fluorine 0-5 to 1 0 p.p.m. for at least the first eight years of life, that is to say before calcification of the dental enamel is complete (vide Murray and Wilson, 1946). Observations on fluorosis and nutrition in Morocco have made it likely that the effect of fluorine on the development and structure of the dental enamel depends very much on the state of general nutrition (Murray and Wilson, 1948). In certain Oxfordshire villages where severe dental fluorosis is seen amongst the inhabitants, no evidence of developed skeletal fluorosis was found (Kemp and others, 1942), but there was a remarkable incidence of changes in the spines of children of the type described by Scheuremann (1921 and 1936) as kyphosis dorsalis juvenilis! In one school at least a third of the children were affected. The worst cases were seen in the lower social classes, among the younger members of large families, or in children with a history of defective nutrition in the early years. A group of poor Oxford city children examined at this time?the incidence of dental fluorosis in Oxford city as a whole is negligible? showed no such changes. In general the children showi","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"2 1","pages":"66 - 70"},"PeriodicalIF":0.0,"publicationDate":"1948-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.2.2.66","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63774907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ExcepUn so far as the occurrence of large-scale epidemics has provided opportunities for differential observation, there is available little well-accredited information concerning the liability of persons of non-European stock to diseases not commonly current in their normal habitat or of the liability of persons of European stock to diseases prevalent in Africa, Asia, and Oceania. This is necessarily so, because of the paucity of statistical machinery in countries which are not as yet highly industrialized and in countries which have no long tradition of occidental medicine. It is therefore unnecessary to expand the ensuing account by reference to current literature or to emphasize at length the peculiar opportunities which Army hygiene offers for a scientific study of this sort. Information about morbidity and mortality with respect to troops of different ethnic origin supplied by Army medical authorities has evidently two outstanding advantages in so far as:
{"title":"The medical ethnography of the second World War.","authors":"L HOGBEN, M M JOHNSTONE, D MULLINGS","doi":"10.1136/jech.1.4.251","DOIUrl":"https://doi.org/10.1136/jech.1.4.251","url":null,"abstract":"ExcepUn so far as the occurrence of large-scale epidemics has provided opportunities for differential observation, there is available little well-accredited information concerning the liability of persons of non-European stock to diseases not commonly current in their normal habitat or of the liability of persons of European stock to diseases prevalent in Africa, Asia, and Oceania. This is necessarily so, because of the paucity of statistical machinery in countries which are not as yet highly industrialized and in countries which have no long tradition of occidental medicine. It is therefore unnecessary to expand the ensuing account by reference to current literature or to emphasize at length the peculiar opportunities which Army hygiene offers for a scientific study of this sort. Information about morbidity and mortality with respect to troops of different ethnic origin supplied by Army medical authorities has evidently two outstanding advantages in so far as:","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"1 4","pages":"251-75"},"PeriodicalIF":0.0,"publicationDate":"1947-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.1.4.251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27790157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"School medical inspections, their value and limitations.","authors":"I GORDON","doi":"10.1136/jech.1.4.238","DOIUrl":"https://doi.org/10.1136/jech.1.4.238","url":null,"abstract":"investigation on 2","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"1 4","pages":"238-50"},"PeriodicalIF":0.0,"publicationDate":"1947-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.1.4.238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27790156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Studies on age and wastage in industrial populations; age and incidence.","authors":"R PADLEY","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"1 4","pages":"13-37"},"PeriodicalIF":0.0,"publicationDate":"1947-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1012509/pdf/brjsocmed00004-0002.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27790155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public health statistics provide a wealth of material with reference to the relation of age to mortality risk from individual diseases; and it has long been customary to adjust mortality rates by means of appropriate standardizing factors to forestall erroneous comparisons of crude deaths in populations of different age structure. Within the framework of private practice, civilian medicine provides no comparable opportunities for an exact study of the relation of age to risk of contracting diseases, other than such as are certifiable to public health authorities or such as are speedily fatal. Indeed current medical treatises and articles abound with figures for proportions of cases examined in different age groups cited as an indication of the liability of individuals to contract a particular disease in a given age group. It should be but is not in fact needless to remark that this procedure is highly misleading. Naturally, the physician meets very few cases of peptic ulcer among males between the ages of 95 and 99 inclusive, for the simple reason that there are in fact very few males alive at that age. The practice of putting on record such case-age distributions, in contradistinction to age-incidence distributions exhibiting frequency of onset related to the appropriate population at risk at a given time of life, is a counsel of despair consequent upon the difficulty of delimiting the population from which a civil hospital draws its patients, and hence of defining the relevant demographic data for drawing correct conclusions. Correct information of this sort is of value both because it may furnish clues for an attack on the nature of the ageing process, and because it is a prerequisite of medical man-power planning in a society with a swiftly-changing age-composition. The Army, with an all-in system of social medicine and a complete population census, therefore offers a unique opportunity for studying the relation of age to
{"title":"The relation of morbidity to age in an army population.","authors":"L HOGBEN, M M JOHNSTONE","doi":"10.1136/jech.1.3.149","DOIUrl":"https://doi.org/10.1136/jech.1.3.149","url":null,"abstract":"Public health statistics provide a wealth of material with reference to the relation of age to mortality risk from individual diseases; and it has long been customary to adjust mortality rates by means of appropriate standardizing factors to forestall erroneous comparisons of crude deaths in populations of different age structure. Within the framework of private practice, civilian medicine provides no comparable opportunities for an exact study of the relation of age to risk of contracting diseases, other than such as are certifiable to public health authorities or such as are speedily fatal. Indeed current medical treatises and articles abound with figures for proportions of cases examined in different age groups cited as an indication of the liability of individuals to contract a particular disease in a given age group. It should be but is not in fact needless to remark that this procedure is highly misleading. Naturally, the physician meets very few cases of peptic ulcer among males between the ages of 95 and 99 inclusive, for the simple reason that there are in fact very few males alive at that age. The practice of putting on record such case-age distributions, in contradistinction to age-incidence distributions exhibiting frequency of onset related to the appropriate population at risk at a given time of life, is a counsel of despair consequent upon the difficulty of delimiting the population from which a civil hospital draws its patients, and hence of defining the relevant demographic data for drawing correct conclusions. Correct information of this sort is of value both because it may furnish clues for an attack on the nature of the ageing process, and because it is a prerequisite of medical man-power planning in a society with a swiftly-changing age-composition. The Army, with an all-in system of social medicine and a complete population census, therefore offers a unique opportunity for studying the relation of age to","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"1 3","pages":"149-81"},"PeriodicalIF":0.0,"publicationDate":"1947-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.1.3.149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28803052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
On the eve of new legislation which will affect the results of illness for hospital patients, it seems opportune to discuss the present neecLfor an almoner's services on a medical ward and what it is likely to be in the future. In 1943 a study was carried out in this department of a group of patients admitted to a medical ward during a period of six months, and it was concluded that 70 per cent, of the patients required an almoner's supervision or help (Brown and Carling, 1945). Since that date an almoner has been attached as social worker to the department, and her duties have included the social care and supervision of patients while in the ward and after discharge. A further follow-up study has now been carried out in order to find out what difference this has made. The main questions to be answered are: what proportion of medical patients require the services of an almoner, what are the main social problems with which the almoner has to deal, how much almoning time is needed if medical social supervision is to be effective, and how can the almoner's services be integrated most efficiently with those of the medical staff ?
{"title":"Social service for a medical ward.","authors":"I F BECK, F V GARDNER, L J WITTS","doi":"10.1136/jech.1.3.197","DOIUrl":"https://doi.org/10.1136/jech.1.3.197","url":null,"abstract":"On the eve of new legislation which will affect the results of illness for hospital patients, it seems opportune to discuss the present neecLfor an almoner's services on a medical ward and what it is likely to be in the future. In 1943 a study was carried out in this department of a group of patients admitted to a medical ward during a period of six months, and it was concluded that 70 per cent, of the patients required an almoner's supervision or help (Brown and Carling, 1945). Since that date an almoner has been attached as social worker to the department, and her duties have included the social care and supervision of patients while in the ward and after discharge. A further follow-up study has now been carried out in order to find out what difference this has made. The main questions to be answered are: what proportion of medical patients require the services of an almoner, what are the main social problems with which the almoner has to deal, how much almoning time is needed if medical social supervision is to be effective, and how can the almoner's services be integrated most efficiently with those of the medical staff ?","PeriodicalId":84321,"journal":{"name":"British journal of social medicine","volume":"1 3","pages":"197-208"},"PeriodicalIF":0.0,"publicationDate":"1947-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jech.1.3.197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28803054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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