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

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London County Council 1932

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

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32
private doctors and of direct applications from the parents of children. In addition
to the 1,234 nominations received during 1932, there were 41 nominations remaining
for consideration at the end of 1931, which made a total of 1,275 nominations to
be dealt with by the section during the year.
The distribution of these nominations throughout the year was in accordance
with past experience. During the months from April to September, inclusive,
606 children (263 boys and 343 girls) were recommended, and during the remainder
of the year 628 (243 boys and 385 girls). This confirms the opinion that rheumatism
is by no means confined to the so-called "rheumatism months," and that the sex
ratio of the disease is upset during the summer months by an increase in the number
of boys affected.
From the beginning of May the task of dealing with so large a number of
children was lightened by the provision of more beds at Queen Mary's hospital,
Carshalton, and of accommodation at the Downs hospital, Sutton, for children
convalescent from rheumatic attacks and for cases of advanced heart disease, for
both of which categories the public provision was quite inadequate.
Hospital treatment or convalescence was provided for 953 children (861 first
admissions and 92 re-admissions). Of these 428 were boys and 525 girls. The
medical referees reported that 73 of the children nominated for admission to
hospital were not suitable for hospital treatment or convalescence under the scheme.
Parents refused treatment for their children in 70 cases; 38 children were admitted
to other hospitals after being nominated to the section for treatment; one child died
of diphtheria whilst awaiting consideration, and a girl received convalescent treatment
through the general hospitals organisation as she was more suitable for a
convalescent home for adults. Of the remaining 139 nominations, 69 had been
reported suitable for treatment and were awaiting admission to hospital at the end
of the year; there were 10 nominations received during the last week in December,
the refereeing of which was undertaken in the beginning of 1933, and there were 60
children nominated early in the year who could not be considered for treatment
owing to the shortage of beds before May and were left to voluntary agencies to
deal with.
In order to preserve statistical continuity with former reports the cases
admitted to Queen Mary's hospital, Carshalton, and those admitted to High Wood
hospital, Brentwood, are analysed separately. These children had not previously
had hospital treatment under the scheme. During the year 534 (255 boys and 279
girls) were treated at Queen Mary's hospital, Carshalton. and 189 (53 boys and 136
girls) at High Wood hospital, Brentwood. The average age of these children on
being accepted fpr treatment was about the same as that of those admitted last
year—nine and a half years. The age of onset of the first symptoms of rheumatism
was ascertained from the histories of 689 of these children. In 286 children (41 per
cent.) the onset was in the 6-8 age period, which agrees with the findings of the
investigation of 1.700 case histories recorded in the report for 1930.

The variety of rheumatism from which these children were suffering was:—

Boys.Girls.Total.
Articular rheumatism229299528
Chorea79116195
308415723

There were 35 cases (15 boys and 20 girls) of acute articular rheumatism
amongst these children and 13 cases (6 boys and 7 girls) of acute chorea. These
children were admitted to hospital within a few hours of their being reported, through
the valuable co-operation of the medical superintendents of Queen Mary's hospital,
Carshalton, and High Wood hospital, Brentwood. This co-operation could not be
more fully demonstrated than by the fact that during the past three years every
child reported to be suffering from acute rheumatism or acute chorea and certified
by a medical referee for treatment as an acute case, has been provided with
immediate treatment in one of these hospitals.