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136
Annual Report of the London County Council, 1910.
The number of definitely rheumatic children was 133 (boys 59, girls 74), giving a percentage
of 5.2 per cent. at all ages and 6.8 per cent. in senior departments. Taking representative schools
the percentages of rheumatic cases were:—
St. Anne's (Dean-street)—Good class, small shopkeeper,
largely foreign Jews 6.9
Ann-street—Average class 7.2
Baltic-street—Very poor, much destitution 4.9
It has apparently no relation to social position, and, if anything, seems less common among the poor.
It must, however, be remembered that a bad case of rheumatism has not the same chance of surviving
among the very poor as among better classes socially. The 133 cases were carefully examined as
to the throat conditions, the lymphatic tissues of the throat being particularly susceptible to the
rheumatic poison and probably one of the main portals of entry.
No signs of throat abnormality 75
Tonsillotomy had been previously performed 3
Slight enlargement of tonsils 21
Considerable enlargement of tonsils 11
Great enlargement of tonsils 16
Adenoids only (producing signs of obstruction) 7
There was, therefore, abnormality in 58, or 43.6 per cent., of the rheumatic cases. The usual
percentage requiring operation in school children is 7 per cent. according to Mr. Macleod Yearsley, and
8 per cent. according to the returns massed by the Board of Education from five million children.

The data of certain rheumatic affections as anaemia could not be determined. Chorea was
noted twice as frequently in girls as boys.
In about two-thirds of the 133 rheumatic cases there was something of a rheumatic nature
in the family. There was noted—
No rheumatic history in family 49
Doubtful rheumatism 25
Rheumatic history in mother 39
Rheumatic history in father 18
Rheumatic brother or sister 26
Rheumatic, more than one member (father, mother, brothers
or sisters) 18
Report on an
East End
School.
The following is condensed from a very full account of an East-End school as made by
Dr. Hawkes, the school doctor, after careful enquiry and personal observation.
Situation.—The School is surrounded except on the north-east by small, mean houses and
gasometers. On the open ground to the north-east is the borough council depot for road metal and
stores. A destructor there had to be abandoned on account of the smells and dust which it caused.
The district so far back as 1848 is described as covered with foul drains and ditches, with cesspools and
reservoirs for every conceivable kind of filth, so that the odour given forth from this place is beyond
conception disgusting. It spreads to a great distance and is complained of by all as an intolerable
nuisance." Now it is not more remarkable than any other East-End district and better than many
which might be selected elsewhere.
Population.—The population is mostly London born, although such names as Dupuy, Dongray,
Jacques, Chaitre, Lefevre, Dummett, Nadal, shown foreign descent; the "weavers lights" in many of the
houses confirm this. There are very few Hebrews. The social grade of the parents is just clear of the
submerged tenth. Very few are in permanent work. The woman is often the breadwinner, the man
seeking work. Evidence of drink was forthcoming but not abundant. The public-houses visited on a
Saturday night were mostly empty. Large families are common but the children are seldom all
alive. Overcrowding at night does not depend on the number of rooms occupied. The paucity of
bedclothes, want of fuel and necessity for conserving warmth being deemed more important than the
need of fresh air. Much of the prevalent anaemia in Dr. Hawkes' opinion is due to this overcrowding.