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 1936
[Report of the Medical Officer of Health for London County Council]
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surgical, 62.6 (63.4) per cent. Of the total number of 1,367 in all categories, 56.3
(59.2) per cent. were at work, 5.6 (6.5) per cent. were fit for work but were unemployed,
31.2 (29.3) per cent. were unable to work (including cases receiving further
residential treatment).
Children.—The particulars obtained as to the after histories of children discharged
under 16 years of age in 1930 relate to 641, of whom 206 are pulmonary
and 435 non-pulmonary.
The mortality records are as follows, the figures in brackets referring to last
year's enquiry into the 1929 cases:—
Table 50.
| Classification | Total | Percentage alive five years after discharge | Percentage dead |
|---|---|---|---|
| A | 153(132) | 91.5(91.7) | 8.5( 8.3) |
| B1 | 6(2) | 66.7(100.0) | 33.3( — ) |
| B2 | 27(22) | 33.3 (45.5) | 66.7(54.5) |
| B3 | 20(17) | -(5.9) | 100.0( 94.1) |
| Non-pulmonary | 435(419) | 90.8 (90.3) | 9.2(9.7) |
The mortality rates of the non-pulmonary cases classified according to the
location of the disease are as follows:—
Table 51.
| Location of disease | Total | Percentage alive five years after discharge | Percentage dead |
|---|---|---|---|
| Hip | 42(52) | 92.9(84.6) | 7.1(15.4) |
| Spine | 52(40) | 73.1(75.0) | 26.9(25.0) |
| Other bones | 88(108) | 94.3(94.5) | 5.7(5.5) |
| Glands | 231(181) | 93.1(92.3) | 6.9(7.7) |
| Other parts | 22(38) | 90.9(92.1) | 9.1(7.9) |
Of the 395 surviving non-pulmonary cases, 157 were at school and 111 at work.
The pulmonary cases class A (i.e., T.B. minus) have been the subject of inquiry
in some detail by Dr. F. J. Bentley, divisional medical officer, for, whilst pulmonary
tuberculosis with positive sputum in childhood is universally recognised as a rare
and grave condition, less certainty exists as regards the extent and outcome of the
disease when tubercle bacilli have not been demonstrated.
A preliminary survey showed that 171 T.B. minus children were discharged in 1930 and yielded the following results five years later:—
| No. | Percentage | |
|---|---|---|
| Alive | 125 | 73.1 |
| Dead | 19 | 11.1 |
| Untraced | 27 | 15.8 |
| Total | 171 | 100.0 |
As the public health department receives information of all deaths from tuberculosis
occurring within the county, it has always been assumed that the untraced
are more likely to be alive than dead. This view has received some support in this
instance as the special inquiry has brought to light 15 out of the 27 previously recorded
as untraced and all these 15 were alive.
As regards the 19 children who were ascertained to have died by the end of
the 5-year period, detailed inquiry has provided a basis for the attitude held in
the department that the commonly encountered childhood type of pulmonary
tuberculosis fares favourably, and that the children who die within five years from
the date of receiving treatment for pulmonary tuberculosis were either acutely ill
when under residential treatment or were suffering from the adult type of the
disease with definite lesions of the lung substance, or that they succumb to some
other illness.