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
London County Council 1925
[Report of the Medical Officer of Health for London County Council]
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alternately for precisely the same behaviour, and consequently, on a basis of
increased irritability there is built up a superstructure of neurosis, the child unconsciously
resenting the difference in treatment. These results follow many of
the infections, but are much more serious and more marked in the severer condition
of encephalitis lethargica. It would appear that convalescent treatment away from
the irritation of clashing personalities in home life is needed in all types of illness
affecting, to a greater or less extent, the central nervous system. The duration and
nature of such treatment should be proportionate or appropriate to the severity of
the attack.
Special institutional
treatment.
The children are only admitted on the application of the Council or Boards of Guardians, and the following table shows the age and sex distribution of cases sent in by the two authorities.
| Age and sex. | 0—. | 5—. | 10-15. | Total. | ||||
|---|---|---|---|---|---|---|---|---|
| F. | ||||||||
| Sent by Council | 15 | 7 | 32 | 30 | 48 | 38 | ||
| Sent by Guardians | — | — | 3 | 3 | 10 | 3 | 13 | 6 |
Of the children discharged, three were sent home at the request of the parents,
two were certified as having sufficiently improved to warrant discharge, and two
were sent home as being incapable of control, of whom one died shortly after her
discharge. The institution is divided into four pavilions, each capable of providing
for 25 children, with two dormitories in each pavilion. The dining and living rooms
are spacious and airy. The hospital is situated on high ground, there is adequate
playing ground accommodation, and the general conditions at the institution are
eminently favourable to the convalescence of debilitated children. Appropriate
treatment is given, and the necessary attention devoted to education and training
as far as it can be done.
Reading and writing, etc., drawing, painting, basket and raffia work are taught.
The medical officer in charge made a classification of the first 50 cases dealt with at the institution, from which it appears that the frequency of the following recognised post-encephalitic symptoms was as follows, some children being included under more than one group.
| 1. Quiet and well-behaved | 12 cases. | 5. Paralytic and badly behaved.. | 7 cases. |
| 2. Mischievous and quarrelsome | 18 „ | 6. Dull and stupid | 10 „ |
| 3. Vicious and spiteful | 9 „ | 7. Severe Parkinsonian .. | 5 ,, |
| 4. Paralytic and well-behaved | 1 case. | 8. Slight Parkinsonian | 9 „ |
At first there were definite indications, in the majority of cases, of a marked
improvement both in respect of sleep and conduct. This was no doubt accounted
for, in part, by the change of environment. The improvement, however, was not
uniformly sustained, and it was found that the cases displaying serious disturbances
of behaviour alternate between exacerbations of temper or viciousness, and periods
of docility or better conduct. The period of observation of the cases, up to the
present, is too short to allow of any definite conclusions as to the prospects in most
cases. It is clear, however, that there are two types which present special difficulty
—namely, the mentally deranged and violent cases, and those showing Parkinson
symptoms.