Chronic Alcoholism

MORE scientific interest in the incidence of chronic alcoholism is now being shown and a "Memorandunm on Alcoholism" has recently been prepared by a Joint Committee of 'rhe British Medical Association and the Magistrates Association (1961). The need for more intensive research has been emphasized, especially into the nature and size of the problem. Assessments of the incidence of chronic alcoholism in various countries have usually been based on the estimation formula devised by E. M. Jellinek and adopted by the World Health Organisation (W.H.O.) Expert Committee on Mental Health Alcoholism SubCommittee 1951. This formula assumes that if the percentage contribution of alcoholism to cirrhosis of the liver is known, it is then possible to determine from reliable autopsy reports the total number of alcoholics with complications existing in a population in any given year. Recently there has been severe criticism of the accuracy of the original formula and nmodifications have been suggested by Seeley (1959) and Brenner (1959). Jellinek (1959) has admitted that the formula should no longer be retained and that field studies are necessary. This publication reports a field study of the incidence of chronic alcoholism in a rural community in which we were intimately concerned. The sample analysed is small but it is suggested that further personal studies of this type from other areas in Northern Ireland would result in a more accurate estimate of the size of the problem. MATERIAL. The area studied was that served by the Downe Hospital, Downpatrick, to which, in 1958, we were acting as Consultant Physicians. We thus had close personal contact with all the practitioners using the hospital and a fairly intimate knowledge of the countryside and its population. The total population of all the practices in this zone in that year, obtained from the General Health Service Board for Northern Ireland, was 40,216. The area involved approximates to the two Urban Districts of Downpatrick where the County Mental Hospital is also sited and that of Newcastle, with the Rural District of Downpatrick. The predicted total population for these districts calculated from the 1951 Census for Northern Ireland (Registrar General, 1953), and making allowance for an inter-censal increase, was 40,024, which agrees closely with the actual number obtained from the Board. It was possible, therefore, to use the 1951 Census figures with fair accuracy, and these have been applied in the calculations. In the county of Down the percentage …