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

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London County Council 1934

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

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The causes of retirement of teachers who have left the service on medical Breakdowns,
grounds are set out below :—

Table 54.

20-2930-3940-4950-5455-5960 +
Respiratory diseases—-
Nervous Diseases—
Gastro-intestinal disease1523471716
Kidney diseases-----221115
Defects of vision13619
Diseases of larynx1212
Exophthalmic goitre235
General debility1116119
Yearly average1369.2

*One case of eczema, two of septicaemia, three of anaemia and four each of diabetes and
uterine disorder.
Comparing the incidence of "breakdowns" in the present series with that
shewn in the table issued in the Annual Report for 1929 (vol. III, p. 143), the
following interesting facts emerge:—
(a) The total number of "breakdown" cases in each period is very nearly
the same, i.e., 1930-1934, 411; 1925-1929, 417.
(b) The cases of pulmonary tuberculosis are now considerably lower.
(c) There is a considerable rise in the prevalence of rheumatic conditions
during the period under review, and this was particularly obvious in the later
months of 1934.
(d) Ten teachers were obliged to leave the service on account of defective
vision. In two cases the disabling condition was blindness from the effects of
rapidly increasing myopia. There were also two similar cases of teachers at
a secondary and a special school respectively, records of which are not included
in the table. All these teachers had been passed into the service prior to the
commencement of the present century. That the number of these cases is no
higher is probably due to the fact that candidates suffering from severe myopia
are rejected at the entrance examination, the standards used for which are
in conformity with the advice of the Council of British Ophthalmologists.
(e) The total number of teachers invalided out of the service on account
of nervous and mental disorders did not differ greatly in the two quinquennia,
but there is a greater tendency for the mild or functional type to preponderate
over the graver organic disease. It is very difficult, from the records, to
distinguish exactly between the classes; it is particularly common for a
psychosis to be described in the early stage as a nervous breakdown. In both
sexes the largest number of cases occurred in those who were suffering from
definite physical disease, often of a depressing nature, e.g., thyroid disturbance,
colitis, deafness, neuritis and rheumatic conditions and worry following
operations. About one quarter of the total cases invalided out of the service
were of the neurotic type. In seven of the men nervous trouble had first been