London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Kensington 1931
[Report of the Medical Officer of Health for Kensington Borough]
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triple rhythm heard and the heart was slightly enlarged. She was put back to bed for two months, improved,
and in two months was allowed to get up. The same thing occurred. This time she was rested completely for
four months and was put out on a balcony. But when she got up she again developed a triple rhythm, was pale,
and lost weight, so she was put back to bed again. After three months more she seemed to have really got rid
of the infection, and had no further relapse on getting up. In this case there was never any pyrexia, the signs
were never severe though definite, and yet it was over a year before signs of activity disappeared.
(2) Case 2 is reported to show how severe symptoms may develop in a mild case in spite of rest in bed.
A girl aged ten was admitted into hospital with mild chorea. There was no sign of carditis. The choreic
symptoms rapidly improved, but three weeks later the patient, in spite of having been kept in the prone position
during that time, developed rheumatic myocarditis of sudden onset. Within a day or two the pulse became
raised, the heart enlarged; the apex beat diffuse, with the area of cardiac dullness enlarged to the left to three
quarters of an inch external to the nipple line ; there was a gallop rhythm.
In both these cases the course was disappointing. In both cases treatment was begun in the very early
stages and yet in one the disease was very prolonged, and in the other severe involvement of the heart developed.
They are, however, exceptions. The writer would again like to emphasise her opinion that there is still much
investigation to be done on the earliest signs and symptoms of juvenile rheumatism, because the early diagnosis is
of vital importance in that early treatment does usually minimise the duration and severity of the disease.
APPENDIX II.
TABLE I. Vital Statistics of Whole District for 1931 and previous Years.
| Year. | Population estimated to middle of each year. | Births. | Total deaths registered in the district. | Transferable deaths. | Net deaths belong:ng to the district. | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Uncorrected number. | Net. | |||||||||||
| of nonresidents registered in the district. | of resi-dentsnot registered in the district. | Underlyearof age | At all ages. | |||||||||
| Number. | Rate. * | Number. | Rate.* | Number. | Rate per 1,000 net births. | Number. | Rate. • | |||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 |
| 1926 | ‡180,000 B 179,800 D | 2,405 | 2,717 | 15.1 | 2,564 | 14.2 | 816 | 557 | 164 | 60 | 2,305 | 12.8 |
| 1927 | ‡176.700B 176.500D | 2,270 | 2,657 | 15.0 | 2,550 | 14.4 | 656 | 546 | 176 | 66 | 2,440 | 13.8 |
| 1928 | ‡1178,40013 178,200D | 2,184 | 2,559 | 14.3 | 2,477 | 13.8 | 694 | 543 | 213 | 83 | 2,326 | 13.0 |
| 1929 | ‡1176,OOOB 175,800D | 2,139 | 2,544 | 14.4 | 2.889 | 16.4 | 733 | 552 | 213 | 84 | 2,708 | 15.4 |
| 1930 | 176.000 | 2,154 | 2,580 | 14.7 | 2,401 | 13.6 | 749 | 590 | 177 | 69 | 2,242 | 12.7 |
| 1931 | 174,800 __ | 2,111 | 2,485 | 14.2 | 2,646 | 15.1 | 716 | 525 | 188 | 76 | 2,455 | 14.0 |
* Rates calculated per 1,000 of estimated population.
‡ B. Population as estimated by the Registrar-General for the calculation of birth rate.
D. „ „ „ „ „ „ „ death rate.
At Census of 1921.
Area of district in acres (exclusive of area Total population at all ages 175,859
covered by water) 2,291 Total families or separate occupiers 48,001