January 1964 — VOL. 45, No. 1 —
A Blitz on Illness
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It is time for adults to start paying attention
to their health. They have set up clinics and programmes of
immunization which have practically wiped out many diseases
that in former years ravaged their children. They have organized
the United Nations to protect the health of the world. They
have introduced traffic lights and a hundred other safeguards
against accidents. But they give scarcely a thought to their
own personal health until it lapses into illness.
To think constructively about our health is not to indulge
in hypochondria, that morbid mental condition of solicitude
which bores our friends and wrecks our own enjoyment of life.
What we need is a bridge between childhood and adulthood.
Why have the diseases of childhood been so thoroughly beaten?
Is it not because parents and teachers take positive action
to see that preventive measures are administered? The children
have no choice in the matter. We give them tender, loving
care during their infancy and their school years whether they
want it or not.
Then comes a let down. With no one to compel us to use what
medical science offers us, we drift through early adulthood
careless of our health and asking medical science only to
act as a scavenger picking up the pieces of our wrecked constitutions.
Now the time has come to look beyond adolescence to improve
the wellness of people who are in and past their twenties.
The Statistical Bulletin of the Metropolitan Life
Insurance Company had this to say in mid—1963: "The total
mortality is already so low in childhood and early adult life
that further decreases in death rates at these ages would
add comparatively little to the average length of life in
the United States. For example, if all deaths in the first
25 years of life could be prevented, the expectation of life
at birth would be increased only three years."
That is why we need a blitz on illness in the adult age
brackets. Many of the 1,391,000 people in Canada who are 65
years of age and over find themselves trapped by illness which
might have been staved off had they continued to give their
mature bodies the same care as they lavished on the bodies
of their children.
If we take care of our maturing bodies we have a potentially
good mechanism that will operate smoothly for all the years
we live. Instead of building obsolescence into our bodies
during our twenties and thirties and forties, we need to live
in such a way that we shall enjoy our fifties and sixties
and seventies. Let's cut illness down to size by delaying
the deterioration of our bodies and building up resistance.
A philosophical writer published a utopian book called Erewhon
in 1872, in which he included a law that if a man falls
into ill health or fails bodily in any way before he is 70
years old he is to be tried before a jury, and if convicted
he is to be held up to public scorn.
That seems to be rather harsh, but we may not think it altogether
inappropriate when we read the words of one of the world's
present leaders in the fight against disease: Dr. Hans Selye.
Writing in Maclean's four years ago he said: "Aging
can be regarded as a disease. Like any other disease, it is
probably preventable or curable."
About those tensions
It is in the doctor's office that our failure to cope effectively
with adult living stands out in all its unfortunate complications.
The doctor cannot do anything about the pace of the world,
but he can tell us what we ourselves can do to hold our own
in it.
Through countless thousands of years our bodies developed
ruggedly to survive in an earthly jungle. Then suddenly, in
a few short centuries, we built a civilization and we have
failed to adjust ourselves to this entirely different way
of life. Like a farm tractor pounding itself to pieces on
a concrete pavement, we are rattling apart on the highway
of progress. We keep going; we ignore the roadside parks and
the "laybys" where we might turn off and rest for a while
to become accustomed to an altered situation before facing
the next disturbance.
It is not only our digestive systems that suffer. We also
develop circulatory troubles, respiratory troubles, nervous
skin troubles, and emotional and mental upsets. Then we multiply
these by worry.
What we need is to deny the dignity of disease. Illness
is a weakness to be prevented or overcome. Unfortunately,
here is a lesson sadly neglected. Some of us look upon our
ailments as tidbits to be talked about, not critical things
about which something should be done. By gossiping about our
illnesses we suffer them twice over.
There is no separateness between the mind and the body.
Every mental and emotional impression, talked about or locked
up within ourselves, has a physical reaction. Our body tissues
furnish the basis upon which thought processes depend; our
minds affect our bodies because they are able to focus energy
for useful or mischievous purposes.
We need to integrate mind and body so that they work together
harmoniously if we are to enjoy high level wellness. We need
to use our heads.
Prevention and treatment
Diseases of many kinds have been conquered or controlled
within the span of a few years: diabetes by insulin, pernicious
anaemia by liver extract, goitre by iodized salt, rickets
by vitamin D, typhoid fever and similar diseases by modern
sanitation, and many of the acute infections by means of antibiotics.
Thousands of sufferers from these diseases are alive today
and leading useful lives who would have been lost inexorably
only yesterday.
Immunization has been developed for the eradication of many
communicable diseases. Diphtheria, smallpox and tetanus are
now 100 per cent preventable, and poliomyelitis and whooping—cough
are nearly so.
Control in Canada is not yet complete, although we literally
and truly have prevention up our sleeves. There are still
many Canadians who are not immunized in spite of the overwhelming
evidence of the effectiveness of immunization. A few people
in every hundred refuse to accept the protection offered them.
They "fear the needle" or they can't be bothered, or they
think it beneath their dignity to seek safety. For lack of
inoculation, Benjamin Franklin lost a son by smallpox, and
ever after regretted his opposition.
Much of the credit for Canada's good standing in prevention
of communicable disease goes to the Health League of Canada,
a voluntary organization set up in 1919. It waged a hearty
campaign for acceptance of diphtheria inoculation, and here
are the results: in 1924 we had 9,507 cases of diphtheria
and it took the lives of 1,281 people; in 1959, with double
the population, there were no deaths from diphtheria. In the
past few years there have been some cases and some deaths,
a tragic state of affairs when there is a safe, effective,
readily—available preventive measure.
Diabetes is not yet preventable, but the death rate has
been appreciably reduced by earlier diagnosis, control of
body weight, closer medical supervision, use of insulin, and
better adherence to the advice of physicians. It is estimated
that there are 250,000 diabetics in Canada, with many others
not yet detected. Those who are aware of their disease and
treat it with respect have an increasingly favourable outlook,
but when the disease goes undetected it is the forerunner
of many injurious conditions in the heart, blood vessels and
liver.
The great killer
We have an altogether illogical approach to the great killing
diseases. Every automobile accident death is printed in the
newspapers, and if two or three people are killed that makes
it television news also. But no public notice is taken of
the 70,000 people killed every year by heart disease. Many
of these deaths are just as avoidable as are deaths by automobile.
Heart disease is a group of illnesses of which arteriosclerosis,
which is hardening and narrowing of the body's arteries, is
by far the leading type and the most deadly killer.
Protection against development of arteriosclerosis cannot
be taken until the situation has been discovered, and this
is one of the very good reasons for periodical medical examination.
If hardening of the arteries is developing, it can be detected
early, and the physician can take it under his experienced
management. The greater part of his therapy will be directed
toward enabling his patient to live with his condition, to
pursue life at a walk instead of a run, to avoid fatiguing
situations and to beware of emotional upsets.
Heart disease is not something to be taken for granted,
but something we should do something about. That is why the
Heart Foundations of Canada were organized: to reduce death
and disability in view of the occurrence of the disease in
1,400,000 Canadians, with 350,000 of them seriously disabled,
and 72,000 dying in a year.
The heart has enormous powers of recuperation. It can stage
a come—back better than most organs in the body. No one
need be made despondent by the statement: "You have a heart
disease." In fact, the great Sir William Osler once said that
the life of many a man had been saved by a heart attack. What
he meant was that the man who had thus been warned of a weak
heart might live for many years, providing he took care of
his health and confined his activities within the range permitted
by his condition.
Second most deadly
The second most deadly disease is cancer. This name is a
general term for abnormal and destructive growths which attack
organs or tissues of the body.
Although the scientific fight against cancer is the greatest
single project in medical history, the cause or causes of
cancer are not yet known. In recent years it has been possible
to speak of the prevention of cancer, directly by the avoidance
of over—exposure to sunlight and radiation and to noxious
agents such as fumes and tobacco smoke; and indirectly by
maintaining one's maximum health by regular physical examination.
The Canadian Cancer Society reports that the present survival
rate for all cancer is about fifty per cent, which is an increase
of some seven to ten per cent in the past ten years. Part
of this increase is the result of improved treatment techniques,
says the Society, but the major part is due to an ever—increasing
proportion of cases being detected early.
Deaths from cancer in Canada over the past twenty years
show an increase in males and a decrease in females. The increase
in males, reports the Society, is almost entirely due to lung
cancer, which ranks first as a cancer killer.
T.B. is still with us
Tuberculosis, which in 1900 led the list of causes of death
but was pushed down to seventh or eighth place, is not yet
under control in Canada. There are still 6,000 new cases of
tuberculosis being diagnosed every year and there were 785
deaths in 1962.
The World Health Organization standard of control is that
not more than one child in one hundred of school leaving age
reacts to the tuberculin test. With hard work and reasonably
good luck Canada can hope to reach this intermediate goal
by 1967. Then the Canadian Tuberculosis Association and the
ten affiliated provincial associations will rally Canadians
for a final effort to push tuberculosis completely off the
"causes of death" tabulation.
Another campaign for health seems to be overdue—the
effort to have all milk pasteurized. Millions of quarts of
raw milk are consumed annually in Canada, and each sip of
it can carry the germs of undulant fever, bovine tuberculosis,
septic sore throat, scarlet fever, dysentery, and acute diarrhoea
of infancy.
The physician—in—chief of the Hospital for Sick
Children, Toronto, issued a statement which shows that, between
1914 and 1917, bovine tuberculosis was eliminated in Toronto
by the use of pasteurization. "The evidence is incontestable,"
he declared, "where careful studies have been made, that from
15 to 20 per cent of bone, gland and abdominal tuberculosis
in children is of bovine origin, and that scientific pasteurization
absolutely prevents tuberculosis of this nature, and in addition
prevents all milk—borne epidemics."
Rheumatism
Rheumatism is the very broad term commonly applied to a
group of diseases that are characterized by pain, stiffness
of joints, muscles and related structures.
Rheumatism, and arthritis comes under this general head,
affects more than a million Canadians, of whom 285,000 are
disabled, 63,000 being totally or severely so. These diseases
are responsible for nine million days' lost work and more
than $75 million in lost wages annually.
To some degree, practically everyone sooner or later makes
personal acquaintance with arthritis. But the victim is not
in a helpless condition. Every sufferer can be helped in some
way, and the chance is good of being able to maintain a normal
life with only mild limitations. Early diagnosis and proper
treatment will prevent serious disability in about four out
of five patients.
An ultimate medical solution of the rheumatic diseases is
a matter of scientific probability. The remarkable achievements
of scientific medicine in this century create confidence in
eventual success. The principal agency in leading this concerted
attack upon arthritis and other rheumatic diseases in Canada
is the Canadian Arthritis and Rheumatism Society.
An excellent example of co—operative voluntary work
in a blitz upon disease is given by the Firefighters of Canada
in their campaign to help sufferers from muscular dystrophy.
In 1954 they assumed sole responsibility for raising funds
for the Muscular Dystrophy Association, and since then they
have brought in more than fifty per cent of the campaign receipts.
This money enables the Association to conduct major research
projects to solve the problem of this "creeping paralysis"
which claims about 20,000 victims in Canada. Two—thirds
of these are children between the ages of three and thirteen;
few of these will reach adolescence and almost all will die
before reaching maturity.
At least one out of every twenty persons over 65 years of
age has symptoms of Parkinson's Disease, a slowly progressive
malady characterized by stiffness of muscles, slowness of
movement, and tremor.
If the illness is discovered early and treated intensively,
the prospects are good that the sufferer will be enabled to
continue as a useful, functioning member of society for many
years. Public support for a co—ordinated attack is being
sought by the Canadian Parkinsonian Foundation.
It is an irony of nature that our teeth, which decay so
painfully while we live, stop decaying at our death and outlast
all the rest of us. Dental bills run over $100 million yearly
in Canada, but this can be reduced materially by following
a three—phase programme put forward by the Health League:
(1) The addition of one part of fluoride per million parts
of water to public water supplies can reduce tooth decay in
children by 60 per cent or more; (2) Brushing the teeth within
ten to fifteen minutes after eating any food, beginning at
the age of two years, and having a dental check—up every
six months; (3) Eating meals rich in proteins, vitamins and
minerals, and avoiding candy between meals.
Accountable to nature
There are many ailments which we can, in some measure, avoid
by thought and care. Nature holds us accountable for our involuntary
as well as our voluntary behaviour. The poison we take by
mistake, the germ we pick up through carelessness, the injury
we brush off without treatment: these kill just as certainly
as the things we do deliberately.
Some illnesses are treated far too casually. Take measles,
for example. The sign of measles is a rash on the skin, and
that is what most people think of measles as being. But the
victim has a similar type of rash throughout his whole bronchial
tree, and if not cared for he may develop bronchial pneumonia.
In November 1963 it was announced by doctors at Montreal Children's
Hospital that a new vaccine is nearly 100 per cent effective
in preventing measles.
There are uncommon illnesses about which we seldom hear.
Take hemophilia as an instance. This is a miserable affliction,
causing excruciating pain, affecting some 2,000 persons in
Canada. Mortality a few decades ago was ninety per cent in
childhood, but through efforts of the Canadian Hemophilia
Society and scientists this has been materially reduced. In
addition to helping sufferers to stay alive, the Society is
helping them to adjust to society, obtain an education, find
suitable work, and establish families. The development of
blood banks has been an important feature of the treatment,
because the average victim receives 45 transfusions a year.
The Canadian Red Cross is making a distinguished contribution
in supplying this need.
The chances are that you have never heard of the disease
Myasthenia Gravis, a serious muscular disorder which afflicts
about 6,000 persons in Canada. It was not until 1961 that
the Myasthenia Gravis Foundation of Ontario was organized,
but before October 1963 it had found 200 sufferers in eight
provinces. The majority of patients with mild, moderate or
even serious symptoms can be restored to 80 per cent of normal.
Mental disease is not a great killer, but through its disabling
effects it takes up more hospital beds than all other types
of illness together. Donald Sinclair, executive director of
the Ontario division of the Canadian Mental Health Association,
told a community services conference in October 1963: "If
Canada had as many physically ill as there are mentally ill
the government would declare a national emergency."
The subject is so big and so important that it warants a
Monthly Letter to itself.
What is to be done?
Some progress is being made on every disease front by dedicated
research people. More can be done when greater intensity of
research is made possible. That is why every association and
society is campaigning for funds to support the scientists
and extend their work.
But we cannot, in our own interests, sit back waiting for
miracle—working drugs. We have to take such measures
as are open to us at this moment.
First of all comes care of our general health so as to build
up a strong constitution that will be able to cope with particular
onslaughts. Next is to avail ourselves of all the immunizations
available at present. Then we must learn to pay intelligent
attention to the alarm bells of pain, and find out what is
wrong. Let the first symptom of any kind of illness bring
home to you the warning that some part of your body is being
abused. Even a simple headache is nature trying to tell you
something. Obey your common sense impulse to take precautions,
and give your doctor a chance to apply his knowledge.
This is certain: we cannot take high—level wellness
casually out of a bottle. It will come only to those who work
at following its precepts. We smile at the ancient Egyptians
for their fantastic magical prescriptions, but many of us
are equally credulous. We consume great quantities of pills
in an effort to deaden pain we should attend to, and to tranquillize
us over the rough road of personal problems.
We should take our ailments to the physician and listen
intelligently to what he says, and then put into practice
in health the resolutions we made when we were ill.
About putting off
We are in danger of putting off until some tomorrow the
very thing that will make that tomorrow worth living.
All the hints about preserving general health and detecting
diseases in their early stages are useless unless we act on
what we learn. We cannot hope to escape all danger, but we
can see to it that we put right what goes wrong. Life is a
constant process of renewal.
Being half alive isn't good enough, but the second half
leading to top level wellness is something that demands more
than lip service. We must earn it.
That is why the Health League of Canada gives us a reminder
every year through National Health Week, starting this year
on March 8th.
Perhaps, in addition to looking more intelligently to our
personal health, we might press for a century of science and
technology dedicated to mankind along the lines of the highly
successful Geophysical Year. It could develop into a really
effective world—wide blitz on illness.
Published by RBC Financial Group. All editions from the RBC
Letter collection are available on our web site at www.rbc.com/responsibility/letter.
Our e-mail address is: rbcletter@rbc.com.
Publié aussi en francais.
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