London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1931

[Report of the Medical Officer of Health for London County Council]

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69
is formed, until sooner or later the parent, exasperated by the failure which his own laziness or
ineptitude has brought about, takes the child to the police and charges him as being beyond
control.
The home conditions in these cases are almost always bad. Drink and other parental vices,
over-crowding, loss of one or other parent by death or desertion, and the troubles so often
associated with step-parents or foster-parents are among the commonest causes alleged. The
effect of removal of these children into the remand home, where life is regulated by good feeding,
regular sleep and exercise, and well directed discipline, is one of the most striking features of the
work in connection with Ponton-road. In hardly a single instance has there been any real
trouble with children or young persons after admission, and the most refractory of them settle
down in a few days and behave in a normal and rational manner. As in stealing, so in loss of
control, the cause is on the surface.
Much that has been said of loss of control applies to the charge of wandering. Bad home
conditions, incompatibility of temper between the child and his parents, and often ill-treatment,
are among the usual causes. In addition, there is, in these cases, the craving for adventure, the
desire for change and a definite wanderlust, which cannot be considered as pathological entities.
In all 75 boys and 8 girls were admitted to Ponton-road more than once. Of the boys,
70 were admitted twice, 4 three times and 1 on no less than six occasions. No girl came in more
than twice. Of the 75 boys, 35 were admitted for a repetition of the same offence.
Table B shows the number of physical defects found in 765 children; 659 boys and 106
girls. While these figures show a somewhat lower percentage of defects among these children
than those of 1930, they are still, on the whole, above the London average. This is more marked
in the children above school age and in the boys than in the girls.
The group of functional neuroses includes stammer, 12 cases; obvious signs of nervousness,
such as facial spasm, blinking, tremor and the like, 16 cases; somnambulism, 4 cases; and
enuresis and occasional bed-wetting, 59 cases.
Of these last, only about 50 per cent, were probably cases of true enuresis. Of the 55 older
boys reported for enuresis, four were mentally defective and 29 were dull or very dull. Nearly
all had some associated physical or nervous disorder and seven were boys of markedly pool
physique. Among the defects were included stammering (1), somnambulism (1), chorea (1)
disordered action of the heart (1), undescended testicle (1) and orchitis following a kick (1). Ir
three there were signs of rickets in early life, four had enlarged tonsils, and two had valvulai
disease of the heart. One boy had signs of Frohlich's syndrome (adiposity due to unbalancec
secretions of the endocrine glands) and one was suspected of masturbation.
Whether the relation between these defects and the enuresis was one of cause and effect is
not clear. A more likely factor is perhaps the disturbances associated with puberty. The impression
is given that the majority of these cases are not pathological at all, but are the result of
uncorrected bad habits and laziness, and, further, that bed-wetting is part and parcel of the
delinquency and not a cause of it.
All boys known to be bed-wetters are placed in special beds and are called at intervals during
the night. In no case is a boy punished, and every encouragement is given to enable the boys to
overcome the habit.
The percentage of stammerers was 1.5 (11 boys and 1 girl). This figure is not much above
the average for London children generally. There were five cases of only slight occasional stammer,
and in no case were there any special features which could lead one to associate the condition
with the offence with which the child was charged.
Two cases only occurred during the year, one of scarlet fever and one of diphtheria. Both
cases were sent to hospital at once, all contacts isolated and, in the case of diphtheria, swabbed.
There was no spread of the disease. Three other boys were sent to hospital with suspected diphtheria
during the year, but all proved to be negative.
In addition to the defects in the table, 377 children were treated for minor injuries and
ailments, septic sores and the like. Swabs were taken from 37 children for suspected diphtheria
with negative results.
In considering the mental condition of the children, the educational attainments and the
general intelligence, as ascertained by Professor Burt's revision of the Binet Simon tests, have
been taken separately. Each child, with the exception of the "place of safety" cases, who were
admitted for one night only, was given a full mental test and the results recorded. Whenever
possible, a few days were allowed to elapse after admission before the test was given, as it was
found easier to secure co-operation and to gain the confidence of the child when he had settled down
and become accustomed to the home. Owing to the short period of remand and to lack of time,
however, this was not always possible.
Table C is compiled from an examination of 674 children whose records are complete. It
shows the marked disparity that exists between the actual intelligence of the delinquent and his
educational attainments. The age level of the latter is obtained by taking the mean of the reading
and arithmetic ages, and is almost invariably far below the mental age. This is true for both
boys and girls and at all ages, but it is more marked in the older children. In many of these, a
process of deterioration was apparent, and it was evident that they were beginning to forget what
they had learned at school, especially in arithmetic, the level of which was almost always below
that of reading.
Wandering.
Multiple
charges.
Physical
defects.
Functional
nervous
disorders.
Enuresis.
Stammering.
Infectious
Fevers.
Mental
conditions.