Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for London County Council]
Annual Report of the London County Council, 1912.
Deformities.—3,840 (1.59 per cent.) children were noted as having deformities and 1,082 (0.45
per cent.) were regarded as requiring treatment. Amongst the infants the boys with deformities formed
1.35 per cent. of those examined and the girls 0.74 per cent. In the age group 8-9 the proportions
were bovs 1.87 per cent., girls 1.97 per cent., and at age 11-12 boys 1.61 per cent. and girls 2.32 per cent.
The chief deformities noted were bow legs, talipes, and deformities of the chest among younger
children and curvature of the spine among the older children. It is clear, therefore, that many cases of
deformity amongst younger children are in effect due to rickets and the numbers referred to previously
under this heading are to this extent less than they should be.
Infectious diseases.—Very few cases of infectious diseases are found at the routine examinations.
Such cases are usually detected at home or by teachers in the school. In 118 cases or 0.05 of those examined
some symptom of one or other of the infectious diseases was found, but only 46 of these cases were
regarded as requiring medical attention, exclusion from school and home treatment being sufficient for
the remainder. Among the special or urgent cases referred for examination 17 cases of infectious
disease were noted.
Full details of cases of infectious disease amongst elementary school children will be found in
another part of this report. (See page 145).
Malnutrition.—1,068 (0.44 per cent.) children were noted as badly nourished, and of these 1,012
were referred for treatment. In addition to these, 71 children not coming within the special age groups
were found, and 68 of them referred for treatment for malnutrition. These cases, when necessitous, are
usually given milk and cod liver oil in school. The proportion of cases was higher among bovs than
girls, the ratio being 56 to 44. Bethnal-green had 19 per 1,000, Woolwich 18, Bermondsey and Poplar
each 8 per 1,000, Hampstead 7 per 1,000, Stepney and Southwark each 6 per 1,000. Kensington had
less than one per 1,000, Chelsea, Westminster, Finsbury, St. Pancras and the City of London had
iust over one per 1,000 (Appendix X.).
During the third term of 1912 the children were grouped as regards nutrition into four divisions—
(1) good, (2) normal, (3) below normal, and (4) bad, and during this term 497 cases were classed as
definitely "bad." In Woolwich only one such case was reported and this tends to show that the standard
adopted throughout the year in Woolwich must have been much higher, inasmuch as 18 cases in every
1,000 were returned as cases of malnutrition, indeed, many cases which during the third term were classed
in division 3 (i.e., sub-normal) were regarded as cases of malnutrition and referred for treatment for this
cause. The same may be said of Hampstead, where no cases were entered in class 4 during the third
term, and yet on the year's figures this borough shows a rate of 7 per 1,000. Of the 497 cases of definite
malnutrition, Bethnal-green had 160, Stepney 93, Bermondsey 60, Poplar 41, Islington 30, Southwark
22 and Lambeth 20, while no cases were reported in Kensington, Westminster, Hampstead, St. Pancras,
Holborn or Finsbury. In the two boroughs last named, and in some other boroughs also, it must be
assumed that the absence of recorded cases of malnutrition is attributable to the inclusion of such
cases under the heading "3" instead of their being referred to the heading "4."
All cases marked "Nutrition 4" are made the subject of special investigation, stress being laid
on the condition of the home, the food the child receives, adequacy of sleep, etc.
Dr. Thomas has analysed the reports relating to 200 children suffering from malnutrition. He found that the following conditions were noted as being either the main or contributory causes of the deficient nutrition :—
|Conditions of ill-health (apart from tuberculosis)||64|
|Necessitous conditions at home||93|
|Mother at work all day||17|
|Neglect at home||10|
|Prematurity or other adverse conditions at the time of birth||8|
|Infantile illness, chiefly rickets||10|
in no less than 82 instances out of the 200 the conditions of the home were said to be 'good,
and some reports contain notes such as "comfortable home," or "maid kept," Dr. Thomas formed
the conclusion from the history of these cases that a number of the children had only survived the adverse
conditions at birth or subsequent illness by reason of the special care bestowed on them by their parents,
and that had they been born in necessitous circumstances or been neglected they would in all
probabilitv have died.
An attempt was made to assign the main cause of the malnutrition of these 200 cases with the following result:—
|Under feeding due to necessitous conditions||74||37|
|Recent illness—tuberculosis 40, other illnesses 41||81||40.5|
|Congenital debility, prematurity and pre-natal conditions, and infantile|
|No definite cause apparent||13||6.5|