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 1938
[Report of the Medical Officer of Health for Kensington Borough]
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74
APPENDIX I.
ELEVENTH ANNUAL REPORT
on
THE KENSINGTON ACUTE RHEUMATISM SCHEME
(1st October, 1937—30th September, 1938)
BY
JAMES FENTON, C.B.E., M.D., M.R.C.P., D.P.H., and JANET K. AITKEN, M.D., M.R.C.P.
PART I.
General
by JAMES FENTON, C.B.E., M.D., M.R.C.P., D.P.H.
The 11th year of work at the rheumatism centre of the Royal Borough of Kensington was completed on the
30th September, 1938.
The functions of this centre are to assist in the early diagnosis of rheumatism in children (the early treatment
of this disease being of paramount importance), and also to compile statistics with a view to determining
etiological factors and thereby assist in the prevention of the disease.
In 1927, the Minister of Health made regulations under which acute rheumatism became a notifiable disease
in Kensington for a period of three years ; similar regulations were made in 1930, 1933 and 1936. The regulations
define acute rheumatism as denoting the following conditions, occurring separately or together, in a child under
the age of sixteen years:—
(а) Rheumatic pains or arthritis, if accompanied by a rise in temperature.
(b) Rheumatic chorea.
(c) Rheumatic carditis.
| Year. | NUMBER OF NOTIFICATIONS BY— | Total number of notifications. | Total number of patients notified during the year who attended the rheumatism supervisory centre. | |||
|---|---|---|---|---|---|---|
| Medical officers at rheumatism supervisory centre. | Private practitioners. | School medical officers. | Hospitals and other institutions. | |||
| 1927-28 | 32 | 53 | 28 | 46 | 159 | 95 |
| 1928-29 | 37 | 40 | 1 | 27 | 105 | 70 |
| 1929-30 | 12 | 33 | 10 | 26 | 81 | 48 |
| 1930-31 | 9 | 28 | 12 | 17 | 66 | 40 |
| 1931-32 | 12 | 21 | 1 | 7 | 41 | 24 |
| 1932-33 | 6 | 43 | 2 | 7 | 58 | 24 |
| 1933-34 | 11 | 43 | 6 | 3 | 63 | 32 |
| 1934-35 | 4 | 22 | 4 | 1 | 31 | 17 |
| 1935-36 | 9 | 19 | 3 | 4 | 35 | 25 |
| 1936-37 | 10 | 27 | 8 | 12 | 57 | 30 |
| 1937-38 | 18 | 16 | 6 | 9 | 49 | 22 |
| Totals | 160 | 345 | 81 | 159 | 745 | 427 |
It will be noted from the above figures that there has been, during the past year, an increase in the number
of notifications from medical officers at the supervisory centre. This is, no doubt, due to the fact that more
cases are being referred to the centre for diagnosis in the early stages of the disease, before any severe manifestations
have occurred. These cases may be referred by general practitioners or school medical officers, or from other
clinics in the borough; but, as will be seen from another part of this report, children are also being taken direct
to the centre by their parents, who are now beginning to realise the significance of early symptons of rheumatic
disease. For instance, "growing pains" are no longer lightly dismissed as necessary accompaniments of
childhood, as was so often the case in the past.
Epidemiology.
The relationship between poverty and the incidence of the disease has again been confirmed, as during the
period under review by far the greater proportion of cases has occurred in the northern part of the borough—
that is, in the poorer and more overcrowded districts.
It is interesting to note that in several instances more than one member of the same family has attended
the supervisory centre, thus confirming the familial character of the disease.