Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[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:—
1946 | 1945 | 1944 | 1943 | 1942 | 1941 | 1940 | 1939‡ | 1938 | |
---|---|---|---|---|---|---|---|---|---|
No. of rheumatism units | 1 | 1 | 2 | 2 | 2 | 2 | 3 | 5 | 5 |
No. of beds available | 2501 | 250† | 200† | 310† | 170† | 220 | 220 | 900 | 900 |
Average no. of beds occupied | 240† | * | * | * | * | * | * | 800 | 794 |
No. of admissions to units | 545 | 335 | 418 | 555 | 358 | 248 | 302 | 1,542 | 2,030 |
Percentage with cardiac involvement | 62.4 | 60.3 | 68.4 | 66.7 | 67.3 | 40.7 | 321 | 35.4 | 36.7 |
No. of supervisory centres | 22 | 21 | 18 | 16 | 14 | 11 | 13 | 21 | 20 |
No. of sessions | 702 | 471 | 469 | 409 | 272 | 148 | 222 | 598 | 1,090 |
No. of children under supervision, 31st December | 2,440 | 1,821 | 1,600 | 1,483 | 1,080 | 620 | 1,066 | 4,384 | 5,160 |
Total no. of attendances | 8,117 | 5,197 | 4,407 | 4,366 | 3,156 | 1,446 | 1,678 | 5,173 | 5,306 |
No. under supervision of school doctors, 31st December | 187 | 161 | 187 | * | * | * | * | 2,104 | 2,632 |
† 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:—
Number | Percentage of miniatures | |||
---|---|---|---|---|
Miniature films taken | 5,854 | — | ||
Large films taken | 103 | 1.76 | ||
Analysis of large films | ||||
No significant abnormality | 67 | 1.14 | ||
Probably non-tuberculous | 4 | .07 | ||
Lesions probably tuberculous:— | ||||
3 | 22 | .05 | .38 | |
(6) Under dispensary or G.P. supervision | 19 | .33 | ||
Cardio-vascular lesions:— | ||||
4 | 10 | .07 | .17 | |
(6) Acquired abnormality | 6 | .10 | ||
103 | 1.76 |