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100
As was seen above, departures from the normal and diseases of all kinds are more
rife where conditions of squalid poverty exist and rheumatism or at least some aspects
of it appears to be no exception.
The existence of pains in the body and limbs was enquired into. The numbers
admitting to such were as follows :— Good Area. Demolition Area.
Boys 6 19
Girls 7 23
It is not suggested that these pains are necessarily an indication of rheumatic
infection, but their presence indicates some departure from normal good health
on the part of such children.
The majority of the children admitting to pains were the less robust in appearance.
Only 3 of them were considered to be of good nutrition, 28 of average
nutrition and the remaining 24 were below the average. They supplied 20 out of
the 25 children noted as being pale and anæmic, and in 28 of them there was some
slight cardiac abnormality, nothing tangible in itself, yet the clinical appearance
of many of these children was that generally associated with the rheumatic child.
Every child was asked if he had ever attended or been a patient in hospital,
and, if so, the nature of the trouble. Infectious diseases were, naturally, the most
frequent—the better-housed children appeared to have the higher incidence of
exanthemata, but it was thought this was largely due to the well-known fact that,
in crowded areas the children develop these illnesses at a younger age and, consequently,
either never know or forget they have had them.
The number having been treated for rheumatism at hospital or by private doctor
is shown :— Good Area. Demolition Area.
Hospital. Private Dr. Hospital. Private Dr
Boys 2 1 5 Nil
Girls 3 2 2 Nil
From these figures it would seem that rather more children (8) from the better
homes suffered from rheumatism so severe as to require treatment, but with previous
knowledge of this series, it will be readily admitted that it is probably further evidence
of parental observation and care on the part of the better-area parents. Where obvious
defects like running ears and discharging noses and inflamed eyes are not treated
it would be surprising to find the faint signals of the insidious approach of rheumatism
observed and acted upon.
The number of children whose brothers or sisters were said to have been treated
at hospital for rheumatism is as follows :—
Good Area. Demolition Area.
Boys 2 5 (One in P.D. school with very defective
heart).
Girls 2 6
The number of children per family in the worse-housed area was larger than in
the better-housed area, but against this is to be placed the fact that the better
children were brighter, more intelligent and more observant, and probably a truer
estimate of morbidity in the family was obtained from them than from the poorer
children. It appears, then, that rheumatism is more prevalent among the very
poor than among those better situated.
No attempt has here been made to appraise the relative influence of genetic
and environmental factors in producing children inferior in physique, in mentality
and in resistance to disease. To quote Dr. Jas. Kerr, "Potentiality of ultimate
results has been decided before birth," but it is self-evident that adverse environmental
factors will curb, cramp and seriously interfere with the opportunities for
full development. Dr. C. J. Thomas also has said that the defects we find in school
children are but the symptoms of their home conditions.