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

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London County Council 1946

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

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The following table gives a statistical summary of the work of the Council's juvenile rheumatic scheme from 1938 to 1946:—

19461945194419431942194119401939‡1938
No. of rheumatism units112222355
No. of beds available2501250†200†310†170†220220900900
Average no. of beds occupied240†******800794
No. of admissions to units5453354185553582483021,5422,030
Percentage with cardiac involvement62.460.368.466.767.340.732135.436.7
No. of supervisory centres222118161411132120
No. of sessions7024714694092721482225981,090
No. of children under supervision, 31st December2,4401,8211,6001,4831,0806201,0664,3845,160
Total no. of attendances8,1175,1974,4074,3663,1561,4461,6785,1735,306
No. under supervision of school doctors, 31st December187161187****2,1042,632

† Approximate figure. * No records.
X All figures relate to the period ending 31st August.
Investigation was carried out during the autumn and winter months of 1945-46
at certain of the rheumatism supervisory centres into the method of preventing
rheumatic recurrences by small doses of sulphanilamide, which had been reported
on favourably in America. The results were disappointing, and the good results
reported in America were not obtained in London.
An investigation into the blood concentration levels of vitamin A in rheumatic
children in Queen Mary's Hospital, Carshalton, was begun in 1945 in co-operation
with a wader research under Dr. Leitner at other of the Council's hospitals. Although
the number of children concerned was not large, certain conclusions seemed to be
j ustified:—
(i) A low vitamin A blood concentration occurs in the presence of active
rheumatic infection and a raised blood sedimentation rate (E.S.R.).
(ii) Large doses of vitamin A favour a drop in the blood sedimentation
rate, indicating the probability of a subsidence of rheumatic infection.
(iii) In certain instances, the vitamin A blood concentration level seemed
to be a more reliable indication of activity than the blood sedimentation
rate. It appeared that with a high vitamin A blood concentration a
raised sedimentation rate might be safely ignored. If further work
confirms this, the curtailment of the period of treatment in such cases
will render vitamin A investigation well worth while.
Tuberculosis
Mass miniature X-ray examinations were carried out at various centres where
arrangements were made for the voluntary attendance of pupils (of 15 years of age
and over) attending secondary schools, technical colleges, etc.
Investigation
into
sulphanilamide
prophylaxis
Vitamin A
Mass
miniature
radiography

The numbers and results of the examinations of school children were as follows:—

NumberPercentage of miniatures
Miniature films taken5,854
Large films taken1031.76
Analysis of large films
No significant abnormality671.14
Probably non-tuberculous4.07
Lesions probably tuberculous:—
(a) Admitted to sanatorium322.05.38
(6) Under dispensary or G.P. supervision19.33
Cardio-vascular lesions:—
(a) Congenital abnormality410.07.17
(6) Acquired abnormality6.10
1031.76