Category Archives: Heart Disease

Digital autopsies should be standard for probable natural deaths, says study

Digital autopsies should be the first-line approach in postmortem investigations of probable natural death, and should be offered free of charge to families, researchers have said.

About 90,000 autopsies requested by coroners are carried out in England and Wales every year, with the majority of deaths found to be a result of natural causes.

A switch to body-scanning techniques could prove valuable, say researchers, since a traditional autopsy can be upsetting for the bereaved and a number of religions, including Islam and Judaism, teach that a body should be buried quickly and not violated after death.

“The main benefit is about avoiding the autopsy,” said Bruno Morgan, co-author of the research from the University of Leicester. “The autopsy is not just a simple operation, it is opening [the body] up fully, taking all the organs out and slicing them all into pieces.”

CT scans have long been used to aid postmortem investigations, while more recently studies have explored targeted coronary angiography – another CT scanner-based technique that involves inserting a catheter into an artery and is used to reveal whether blockages are present in the coronary arteries, and to investigate the heart itself.

The latter is a major step forward, since one limitation of digital autopsies has been the difficulty of standard CT scans in establishing causes of death such as coronary heart disease.

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The latest study offers a large-scale comparison of the accuracy of the combined CT techniques to traditional autopsy.

“This paper is the first one that has come out and says this is as accurate as autopsy is in this setting. It works and therefore it is a valid alternative,” said Morgan.

Writing in the Lancet, researchers led by a team at the University of Leicester describe how they studied 241 cases of adults who had died suddenly and unexpectedly of natural causes or had died a non-suspicious unnatural death.

Each was assessed by a postmortem CT scan, with targeted coronary angiography successfully carried out in 85% of the cases. Standard autopsies were then carried out for each case, with the pathologists not told about the findings from the body scans.

After excluding 31 cases, including 24 cases for which the cause of death was clearly traumatic, such as a gunshot wound, the team found that the body-scan approach gave a cause of death, based on “the balance of probabilities”, in 92% of cases.

In 11% of this group, results from either the scans or the autopsy were at odds with findings from a combination of the two. Further analysis revealed that these discrepancies were evenly split between errors in the body-scan approach and errors in the traditional autopsy.

The team say the gold standard for postmortem is the use of both traditional autopsy and body scans, but say the findings support a move to using digital autopsy as the first-line technique in cases of probable natural death. Should more evidence be required, they add, a traditional autopsy can subsequently be carried out.

The public are already allowed to request – usually at a cost of about £500, typically paid by the family – that digital autopsies are used for postmortem investigations where appropriate.

But Morgan says that option should be made available free of charge – a service currently only offered by a small number of councils.

“If you don’t want an invasive autopsy on yourself or on your family, you should be raising the debate and saying why can’t the council pay for this?” he said. “It strikes me that it is wrong that we should make people pay for something that is a statutory obligation,” he added.

Dr Mike Osborn, a fellow of the Royal College of Pathologists, said that postmortem investigations are vital in understanding why people die, as well as improving understanding of disease. But he acknowledged that autopsies can be distressing and clash with religious beliefs.

The development of digital autopsies, including those based on CT scans, he added, was exciting and important. While Osborn noted that some conditions still require a diagnosis from a traditional autopsy, he welcomed further research in the field to reduce the number of traditional autopsies required. “The accuracy of cross-sectional imaging postmortem has improved over the last 20 years and is likely to continue to do so,” he said. “The College fully supports further research in this area while reinforcing the need for thorough and robust governance in this emerging field.”

This is what the blood donor service does after an attack – and how you can help | Jane Green

I was overwhelmed by how generously the people of Manchester responded to this horrific attack. Both our blood donor centres in Manchester had queues outside the doors before they even opened. Our national call centre was taking about 1,000 calls an hour by 10am, from people who wanted to help save lives by donating blood.

The response was driven by well-intentioned social media posts from the public. The desire to help was incredible. However we already had enough blood to supply the hospitals treating the victims, and we did not appeal for extra donors. We plan ahead to build in reserves to deal with major incidents. We hope that people who want to help will now become regular donors, because that is how they can best help us save lives when there is a tragedy.

Many people wanted to donate to help that day, but when you donate blood, it is not taken straight to a patient. We need time to test it and process it. The different components such as platelets and red blood cells need to be separated out. Typically, your blood donation will only reach a patient two or three weeks after you donate. The blood used to treat the Manchester victims would have been donated several weeks earlier, and those donors would have been from across the country.

Hospitals order blood from us in advance, without the need for blood to be brought in for each patient. We supply hospitals through our regional stock-holding units (what people refer to as “blood banks”) mainly through routine deliveries. Over Monday night we made 21 deliveries of blood to hospitals in Manchester, including 15 “blue light” emergency deliveries, delivering 346 units of red blood cells. We were able to meet all the hospitals’ requests, and our stocks remained good. We don’t know exactly how this blood was used, and much of the blood from the routine deliveries would have gone to patients not affected by the attack. But this was an exceptionally high level of local emergency demand and many of those precious donations would have been transfused into attack victims.

Trauma patients require more than just red blood cells. They also need platelets to help their blood clot, and other more specialised products: O-negative blood is especially important in emergencies because it can be given to anyone when time is short and you don’t have time to test for blood groups. We always need new O-negative donors because their blood is so valuable.

As Tuesday morning progressed, people began queueing to donate. Some had friends or family members caught up in the incident. We were worried they might be confused or upset about why there was no capacity or urgent need for them to donate that day.


We were inspired to see the diversity of people coming forward, because we need more black and Asian donors

We tried to spread the message about how people could best help across social media and through the press. I was working at Plymouth Grove donor centre, next to Manchester Royal Infirmary, where many victims were being treated, and I spoke to many people face to face. We were inspired to see the diversity of people coming forward, which was moving and very important – because we need more black and Asian donors. Patients benefit from closely matched blood, which will often come from donors of the same ethnicity.

Our message is that blood can best save lives in a tragedy when our stocks are already good through regular donations. Thanks to our loyal army of nearly 900,000 active donors, many of whom give blood three or four times a year, we can do that. But every year many of these donors have to drop out because of age, ill health and many other reasons. We need nearly 200,000 people to register as new donors every year.

If people have been inspired to donate for the first time, please go online, make an appointment, and donate. Blood saves lives, and your donation will help other people in urgent need, and make sure we are again ready for any major incident.

Christy Turlington: ‘The closest I’ve come to death? The birth of my daughter’

Born in California, Christy Turlington Burns, 48, was scouted to be a model at 14 and went on to become one of the original supermodels. After suffering a postpartum haemorrhage in 2003, she took a masters in public health and set up non-profit organisation Every Mother Counts, addressing global maternal health. The charity has partnered with Toms shoes. She is married to actor Ed Burns, has two children and lives in New York.

When were you happiest?
Before kids, when I was 13 or so, on the back of my horse, running at full speed in an open pasture. Post kids, happiness happens often, but in more subtle ways. I now prefer the word “content”.

What is your greatest fear?
I don’t fear anything but fear itself. Fear makes humans behave inhumanely.

What is your earliest memory?
I have a collage of memories beginning around age four: my first walk alone to a store or to school, and early trips to Central America with my mom to visit her family.

Which living person do you most admire, and why?
A midwife named Jennie Joseph. She is a tireless activist for women, family health and equal access to quality maternity care.

What is the trait you most deplore in yourself?
I sometimes set unreasonably high expectations of myself and those around me.

What was your most embarrassing moment?
There are too many to name, but none of them keeps me up at night.

What makes you unhappy?
Government policy decisions that negatively impact the health and wellbeing of women and families.

What do you most dislike about your appearance?
Having to talk about it.

Who would play you in the film of your life?
The world does not need a film about my life.

What is the worst thing anyone’s said to you?
A boyfriend once told me there was always going to be someone smarter, funnier and prettier than me, which at the time felt pretty mean, but it was true.

To whom would you most like to say sorry, and why?
To strangers. Living in New York, I see individuals every day who are invisible to so many. I want to say sorry that so many of us think their pain and suffering is not our own.

What was the best kiss of your life?
The first kiss from my husband and every one since.

What has been your biggest disappointment?
My father’s death before my marriage, and motherhood.

If you could edit your past, what would you change?
I might speed up a few details, but wouldn’t change anything, other than my dad still being here.

How do you relax?
Yoga, running, recreational reading.

What is the closest you’ve come to death?
The birth of my daughter.

What keeps you awake at night?
The fact that at least 300,000 women die every year from pregnancy and childbirth-related issues that are largely preventable.

What is the most important lesson life has taught you?
That I am more than I thought I was.

How would you like to be remembered?
As someone who didn’t waste a minute.

Christy Turlington: ‘The closest I’ve come to death? The birth of my daughter’

Born in California, Christy Turlington Burns, 48, was scouted to be a model at 14 and went on to become one of the original supermodels. After suffering a postpartum haemorrhage in 2003, she took a masters in public health and set up non-profit organisation Every Mother Counts, addressing global maternal health. The charity has partnered with Toms shoes. She is married to actor Ed Burns, has two children and lives in New York.

When were you happiest?
Before kids, when I was 13 or so, on the back of my horse, running at full speed in an open pasture. Post kids, happiness happens often, but in more subtle ways. I now prefer the word “content”.

What is your greatest fear?
I don’t fear anything but fear itself. Fear makes humans behave inhumanely.

What is your earliest memory?
I have a collage of memories beginning around age four: my first walk alone to a store or to school, and early trips to Central America with my mom to visit her family.

Which living person do you most admire, and why?
A midwife named Jennie Joseph. She is a tireless activist for women, family health and equal access to quality maternity care.

What is the trait you most deplore in yourself?
I sometimes set unreasonably high expectations of myself and those around me.

What was your most embarrassing moment?
There are too many to name, but none of them keeps me up at night.

What makes you unhappy?
Government policy decisions that negatively impact the health and wellbeing of women and families.

What do you most dislike about your appearance?
Having to talk about it.

Who would play you in the film of your life?
The world does not need a film about my life.

What is the worst thing anyone’s said to you?
A boyfriend once told me there was always going to be someone smarter, funnier and prettier than me, which at the time felt pretty mean, but it was true.

To whom would you most like to say sorry, and why?
To strangers. Living in New York, I see individuals every day who are invisible to so many. I want to say sorry that so many of us think their pain and suffering is not our own.

What was the best kiss of your life?
The first kiss from my husband and every one since.

What has been your biggest disappointment?
My father’s death before my marriage, and motherhood.

If you could edit your past, what would you change?
I might speed up a few details, but wouldn’t change anything, other than my dad still being here.

How do you relax?
Yoga, running, recreational reading.

What is the closest you’ve come to death?
The birth of my daughter.

What keeps you awake at night?
The fact that at least 300,000 women die every year from pregnancy and childbirth-related issues that are largely preventable.

What is the most important lesson life has taught you?
That I am more than I thought I was.

How would you like to be remembered?
As someone who didn’t waste a minute.

Christy Turlington: ‘The closest I’ve come to death? The birth of my daughter’

Born in California, Christy Turlington Burns, 48, was scouted to be a model at 14 and went on to become one of the original supermodels. After suffering a postpartum haemorrhage in 2003, she took a masters in public health and set up non-profit organisation Every Mother Counts, addressing global maternal health. The charity has partnered with Toms shoes. She is married to actor Ed Burns, has two children and lives in New York.

When were you happiest?
Before kids, when I was 13 or so, on the back of my horse, running at full speed in an open pasture. Post kids, happiness happens often, but in more subtle ways. I now prefer the word “content”.

What is your greatest fear?
I don’t fear anything but fear itself. Fear makes humans behave inhumanely.

What is your earliest memory?
I have a collage of memories beginning around age four: my first walk alone to a store or to school, and early trips to Central America with my mom to visit her family.

Which living person do you most admire, and why?
A midwife named Jennie Joseph. She is a tireless activist for women, family health and equal access to quality maternity care.

What is the trait you most deplore in yourself?
I sometimes set unreasonably high expectations of myself and those around me.

What was your most embarrassing moment?
There are too many to name, but none of them keeps me up at night.

What makes you unhappy?
Government policy decisions that negatively impact the health and wellbeing of women and families.

What do you most dislike about your appearance?
Having to talk about it.

Who would play you in the film of your life?
The world does not need a film about my life.

What is the worst thing anyone’s said to you?
A boyfriend once told me there was always going to be someone smarter, funnier and prettier than me, which at the time felt pretty mean, but it was true.

To whom would you most like to say sorry, and why?
To strangers. Living in New York, I see individuals every day who are invisible to so many. I want to say sorry that so many of us think their pain and suffering is not our own.

What was the best kiss of your life?
The first kiss from my husband and every one since.

What has been your biggest disappointment?
My father’s death before my marriage, and motherhood.

If you could edit your past, what would you change?
I might speed up a few details, but wouldn’t change anything, other than my dad still being here.

How do you relax?
Yoga, running, recreational reading.

What is the closest you’ve come to death?
The birth of my daughter.

What keeps you awake at night?
The fact that at least 300,000 women die every year from pregnancy and childbirth-related issues that are largely preventable.

What is the most important lesson life has taught you?
That I am more than I thought I was.

How would you like to be remembered?
As someone who didn’t waste a minute.

‘Pro-vegetarian’ diet could halve chance of obesity

A diet which reduces or even excludes meat and animal produce in favour of vegetables, fruit and grains could halve people’s chances of becoming obese, according to new research.

A study carried out in Spain describes the benefits of what researchers call a “pro-vegetarian” diet which does not exclude meat and dairy products but reduces them. It has also been called a “flexitarian” diet – basically vegetarian, with meat and fish consumed occasionally.

Some 16,000 university graduates were tracked from 1999 for 10 years, by which time 584 were obese, according to findings presented at the European Congress on Obesity in Porto, Portugal.

At the beginning of the study, participants completed detailed food questionnaires which were scored to establish how pro-vegetarian their diet was. They got more points for eating from seven plant food groups – vegetables, fruits, grains, nuts, olive oil, legumes (such as peas, beans, and lentils) and potatoes.

Points were then deducted for foods from five animal groups – animal fats, dairy, eggs, fish and other seafood, and meat.

The researchers compared the 20% whose diet included the most animal products with the 20% who ate the least. They found that those whose diet was the most vegetarian were 43% less likely to become obese.

Although fish was included in the animal foods group, the results showed that there was very little difference in the amount of fish that any of the participants ate, so had little impact on obesity rates.

But there was a significant difference in the amount of meat eaten – those who ate most consumed about 200g a day (roughly the weight of a small chicken breast or a seven ounce steak), while those who ate least consumed 142g. There was an even larger difference in the consumption of vegetables – 348g in the meat-eating group and 731g for those whose diet was the most vegetarian. The same applied to fruit consumption – 191g versus 531g.

“Our recommendation is to eat less meat,” said Prof Maira Bes-Rastrollo, one of the authors. “Don’t increase the consumption of animal foods. Prefer plant-based foods to animal foods.”

The study’s weakness is that it is observational – it did not recruit people eating a mainly vegetarian diet in order to compare them with a group of meat eaters, nor did it attempt to change the behaviour of participants.

The pro-vegetarian diet in the study is very similar to the Mediterranean diet. Gaynor Bussell, a dietician and member of the British Dietetic Association said: “We have known for a while that a healthy plant-based diet is associated with less obesity and this new evidence confirms this.

“Other factors could be accounting for the lower obesity in this group; I would also add that although scored negatively, foods such as fish, some meat and dairy are not associated with obesity but it is about the overall balance of the diet. The Mediterranean diet with its reliance on fruit, veg, nuts, beans and little meat is probably an ideal mix and is also associated with lower obesity rates.”

Sarah Toule from the World Cancer Research Fund said: “A mainly plant-based diet not only helps reduce obesity risk, but our own evidence shows it helps reduce your cancer risk too.

“Eating more portions of vegetables and fruit, cooking from scratch and including a wide variety of colours on your plate are all good ways to improve your diet.”

Popular social media sites ‘harm young people’s mental health’

Four of the five most popular forms of social media harm young people’s mental health, with Instagram the most damaging, according to research by two health organisations.

Instagram has the most negative impact on young people’s mental wellbeing, a survey of almost 1,500 14- to 24-year-olds found, and the health groups accused it of deepening young people’s feelings of inadequacy and anxiety.

The survey, published on Friday, concluded that Snapchat, Facebook and Twitter are also harmful. Among the five only YouTube was judged to have a positive impact.

The four platforms have a negative effect because they can exacerbate children’s and young people’s body image worries, and worsen bullying, sleep problems and feelings of anxiety, depression and loneliness, the participants said.

The findings follow growing concern among politicians, health bodies, doctors, charities and parents about young people suffering harm as a result of sexting, cyberbullying and social media reinforcing feelings of self-loathing and even the risk of them committing suicide.

“It’s interesting to see Instagram and Snapchat ranking as the worst for mental health and wellbeing. Both platforms are very image-focused and it appears that they may be driving feelings of inadequacy and anxiety in young people,” said Shirley Cramer, chief executive of the Royal Society for Public Health, which undertook the survey with the Young Health Movement.

She demanded tough measures “to make social media less of a wild west when it comes to young people’s mental health and wellbeing”. Social media firms should bring in a pop-up image to warn young people that they have been using it a lot, while Instagram and similar platforms should alert users when photographs of people have been digitally manipulated, Cramer said.

The 1,479 young people surveyed were asked to rate the impact of the five forms of social media on 14 different criteria of health and wellbeing, including their effect on sleep, anxiety, depression, loneliness, self-identity, bullying, body image and the fear of missing out.

Instagram emerged with the most negative score. It rated badly for seven of the 14 measures, particularly its impact on sleep, body image and fear of missing out – and also for bullying and feelings of anxiety, depression and loneliness. However, young people cited its upsides too, including self-expression, self-identity and emotional support.

YouTube scored very badly for its impact on sleep but positively in nine of the 14 categories, notably awareness and understanding of other people’s health experience, self-expression, loneliness, depression and emotional support.

However, the leader of the UK’s psychiatrists said the findings were too simplistic and unfairly blamed social media for the complex reasons why the mental health of so many young people is suffering.

Prof Sir Simon Wessely, president of the Royal College of Psychiatrists, said: “I am sure that social media plays a role in unhappiness, but it has as many benefits as it does negatives.. We need to teach children how to cope with all aspects of social media – good and bad – to prepare them for an increasingly digitised world. There is real danger in blaming the medium for the message.”

Young Minds, the charity which Theresa May visited last week on a campaign stop, backed the call for Instagram and other platforms to take further steps to protect young users.

Tom Madders, its director of campaigns and communications, said: “Prompting young people about heavy usage and signposting to support they may need, on a platform that they identify with, could help many young people.”

However, he also urged caution in how content accessed by young people on social media is perceived. “It’s also important to recognise that simply ‘protecting’ young people from particular content types can never be the whole solution. We need to support young people so they understand the risks of how they behave online, and are empowered to make sense of and know how to respond to harmful content that slips through filters.”

Parents and mental health experts fear that platforms such as Instagram can make young users feel worried and inadequate by facilitating hostile comments about their appearance or reminding them that they have not been invited to, for example, a party many of their peers are attending.

May, who has made children’s mental health one of her priorities, highlighted social media’s damaging effects in her “shared society” speech in January, saying: “We know that the use of social media brings additional concerns and challenges. In 2014, just over one in 10 young people said that they had experienced cyberbullying by phone or over the internet.”

In February, Jeremy Hunt, the health secretary, warned social media and technology firms that they could face sanctions, including through legislation, unless they did more to tackle sexting, cyberbullying and the trolling of young users.

Popular social media sites ‘harm young people’s mental health’

Four of the five most popular forms of social media harm young people’s mental health, with Instagram the most damaging, according to research by two health organisations.

Instagram has the most negative impact on young people’s mental wellbeing, a survey of almost 1,500 14- to 24-year-olds found, and the health groups accused it of deepening young people’s feelings of inadequacy and anxiety.

The survey, published on Friday, concluded that Snapchat, Facebook and Twitter are also harmful. Among the five only YouTube was judged to have a positive impact.

The four platforms have a negative effect because they can exacerbate children’s and young people’s body image worries, and worsen bullying, sleep problems and feelings of anxiety, depression and loneliness, the participants said.

The findings follow growing concern among politicians, health bodies, doctors, charities and parents about young people suffering harm as a result of sexting, cyberbullying and social media reinforcing feelings of self-loathing and even the risk of them committing suicide.

“It’s interesting to see Instagram and Snapchat ranking as the worst for mental health and wellbeing. Both platforms are very image-focused and it appears that they may be driving feelings of inadequacy and anxiety in young people,” said Shirley Cramer, chief executive of the Royal Society for Public Health, which undertook the survey with the Young Health Movement.

She demanded tough measures “to make social media less of a wild west when it comes to young people’s mental health and wellbeing”. Social media firms should bring in a pop-up image to warn young people that they have been using it a lot, while Instagram and similar platforms should alert users when photographs of people have been digitally manipulated, Cramer said.

The 1,479 young people surveyed were asked to rate the impact of the five forms of social media on 14 different criteria of health and wellbeing, including their effect on sleep, anxiety, depression, loneliness, self-identity, bullying, body image and the fear of missing out.

Instagram emerged with the most negative score. It rated badly for seven of the 14 measures, particularly its impact on sleep, body image and fear of missing out – and also for bullying and feelings of anxiety, depression and loneliness. However, young people cited its upsides too, including self-expression, self-identity and emotional support.

YouTube scored very badly for its impact on sleep but positively in nine of the 14 categories, notably awareness and understanding of other people’s health experience, self-expression, loneliness, depression and emotional support.

However, the leader of the UK’s psychiatrists said the findings were too simplistic and unfairly blamed social media for the complex reasons why the mental health of so many young people is suffering.

Prof Sir Simon Wessely, president of the Royal College of Psychiatrists, said: “I am sure that social media plays a role in unhappiness, but it has as many benefits as it does negatives.. We need to teach children how to cope with all aspects of social media – good and bad – to prepare them for an increasingly digitised world. There is real danger in blaming the medium for the message.”

Young Minds, the charity which Theresa May visited last week on a campaign stop, backed the call for Instagram and other platforms to take further steps to protect young users.

Tom Madders, its director of campaigns and communications, said: “Prompting young people about heavy usage and signposting to support they may need, on a platform that they identify with, could help many young people.”

However, he also urged caution in how content accessed by young people on social media is perceived. “It’s also important to recognise that simply ‘protecting’ young people from particular content types can never be the whole solution. We need to support young people so they understand the risks of how they behave online, and are empowered to make sense of and know how to respond to harmful content that slips through filters.”

Parents and mental health experts fear that platforms such as Instagram can make young users feel worried and inadequate by facilitating hostile comments about their appearance or reminding them that they have not been invited to, for example, a party many of their peers are attending.

May, who has made children’s mental health one of her priorities, highlighted social media’s damaging effects in her “shared society” speech in January, saying: “We know that the use of social media brings additional concerns and challenges. In 2014, just over one in 10 young people said that they had experienced cyberbullying by phone or over the internet.”

In February, Jeremy Hunt, the health secretary, warned social media and technology firms that they could face sanctions, including through legislation, unless they did more to tackle sexting, cyberbullying and the trolling of young users.

The work of the Salford venereal diseases clinic – archive, 18 May 1929

On April 1 last year a municipal clinic for venereal diseases was established in Salford, and the first annual report, for the nine months’ working, has just been issued by Dr. E. T. Burke, venereal diseases medical officer for the city. The existence of the venereal diseases scheme of the Ministry of Health implies the existence of a venereal diseases problem, he writes. In pre-war times the question of venereal disease was something of a national taboo. The great – almost inevitable – increase in venereal disease occasioned by the Great War was driven into the public consciousness. “It was realised,” he writes, “that, covered by a carefully fostered conspiracy of silence, the ulcer of venereal disease was gnawing at the very vitals of the national health.

A new generation has sprung up, and the memories of the older generation are short. There has been a tendency to rest upon our oars; and the ancient taboo – the pernicious policy of ‘hush-hush’ – has been gradually reasserting its anaesthetic effect.”

“Campaigns against cancer and consumption are very necessary,” he goes on. “They are popular; they are respectable, and they have a wide appeal both among the medical profession and the laity. An anti-venereal campaign starts with the dice heavily loaded against it. The thought that the venereal problem is but one of very minor importance is fathered by the wish that it might be so.”

Venereal disease prevention poster, 1920.


Venereal disease prevention poster, 1920. Photograph: Smith Collection/Gado/Getty Images

Misleading Returns
After reviewing the various researches to discover the proportion of cases of syphilis in the community, Dr. Burke says that the neat proportion of deaths from syphilis are hidden under various other labels in the mortality lists of the Registrar General. Confidential death certification would go a long way toward turning an annual mass of figures, in many respects both useless and misleading, into something of practical value. The truth as to the killing power of syphilis lay at the bottom of the Registrar General’s statistical well. They found by scientific analysis that about 10 per cent of the total deaths were due to syphilis, and as gonorrhea was about twice as common syphilis the grand total of venereally infected persons was brought to about 500,000 or 14 per cent of the population of the whole country. In the city of Salford, with a population of 250,000 (assuming that the community was infected at a rate no higher than the country generally, there would be at least some 30,000 infected persons. That meant about 1,000 annual fresh infections, and 200 deaths from syphilis every twelve months.

The cost of the clinic in its first year (April to December had been £5,600. It was necessary to consider whether that was justifiable. The devastating economic effect could be gauged by an investigation undertaken by approved societies with a membership of 3,000,000. The average duration of disablement per member per year was found to be: all diseases 7,2 weeks, venereal disease 10,9 weeks. The effect of this in causing a decrease in industrial production and an increase in the cost of living was self-evident. The attitude of the British employer to venereal disease had been either to ignore or penalise it. Both were suicidal policies.

The Care of Children
The report goes on to deal with the actual working of the Salford clinic. It is shown that the total attendances for the nine months were 35,503 (intermediate attendances 26,155) and 1,220 new cases were treated. In comparison with the twelve months’ figures of other big centres, it is seen that the Salford clinic has dealt with more new patients and registered more attendances than any other treatment centre with a similar size of population. Of the total number of patients 21.5 per cent were Manchester residents.

Dr. Burke states that very few children are being treated at the clinic, which fact he regards as unsatisfactory. “It is felt,” he writes, “that school-children suffering from general debility, backwardness, heart disease, epilepsy, &c., should be thoroughly examined for evidence of syphilis.” He also urges the need for a hostel to which women could be admitted while undergoing treatment to enable them to continue in their employment, and he emphasises the necessity of a treatment station within the dock boundaries, with placards, telling of its existence in different languages, to be placed in seamen’s and firemen’s quarters in every ship entering dock. The number of patients belonging to the mercantile marine was 138, 11 per cent of the total.

Manchester Guardian, 18 May 1929.


Manchester Guardian, 18 May 1929.

Are you a doctor in Australia struggling with mental health issues?

The issue of mental health among Australia’s doctors and medical students has been in the headlines. Four junior doctors from one cohort have taken their lives within six months. Last week, Australian gastroenterologist Andrew Bryant died in his office after battling depression.

The National Mental Health Survey of Doctors and Medical Students shows that the profession experiences higher rates of mental illness than the general community. Though doctors report that talking about it is taboo within the high-performing culture of medicine.

Dr Ranjana Srivastava writing for the Guardian said: “When it comes to mental illness, we hear a lot from the experts but not enough from the sufferers. Nothing would be more welcome than the insights of doctors who have endured mental suffering and worse, been on the brink of suicide. What healed them and who helped them? What could their colleagues have said or done differently at the time? What workplace adjustments would have meant the most? These stories are clearly among us – hearing them could illuminate the dark corners of our understanding and help link theory and practice.”

Share your experiences

We’d like to hear from doctors who have experienced mental health issues. What helped you through it? What could your colleagues have done differently at the time? You can share your experiences, anonymously if you prefer, by filling in the encrypted form below. We will do our best to keep your information secure. We will not publish any responses without contacting you first.

In Australia, the crisis support service Lifeline is on 13 11 14. In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255