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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
Willesden 1931
[Report of the Medical Officer of Health for Willesden]
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APPENDIX H.
RHEUMATISM AND HEART DISEASE.
I beg to report in accordance with the following minute of the Education Committee
"With reference to our report of 19th November, 1930 (para. 7), we have had
before us the report on the Joint Conference on Problems relating to those handicapped
by Physical and Psychological defects. The Conference was convened by the Invalid
Children's Aid Association, and the Central Council for the Care of Cripples, and was
held on the 13th and 14th November, 1930. Copies of the report have been sent to
all members of the Education Committee. We particularly desire to direct the attention
of the Committee to that portion of the report dealing with rheumatism in childhood.
Arising out of this, we have asked the School Medical Officer to submit to us
at a future meeting a full report on the whole situation dealing particularly with
rheumatic and heart cases of the kind referred to in the report."—(Education Committee
Minutes, 1930-31, p. 390.)
The Extent of the Problem.
The following figures taken from the Registrar-General's Statistical Report for 1929 show the deaths from Rheumatic Fever and Heart Disease which occurred in England and Wales and Willesden, respectively, in 1929:—
| England and Wales. | Willesden. | |
|---|---|---|
| Rheumatic Fever | 1,417 | 7 |
| Pericarditis | 291 | 3 |
| Acute Endocarditis and Myocarditis | 1,955 | 10 |
| Angina Pectoris | 4,807 | 14 |
| Other Diseases of the Heart | 89,414 | 336 |
| Total—Heart Disease | 96,467 | 363 |
| Total—Rheumatic Fever and Heart Disease | 97,884 | 370 |
It is important to note that Heart Disease and Rheumatic Fever cause the greatest number of deaths year by year. The following table shows the five principal causes of death in 1929 in England and Wales, and Willesden, respectively:—
| Year 1929. | England and Wales. | Willesden. |
|---|---|---|
| Total deaths from diseases of the heart, including Rheumatic Fever | 97,884 | 370 |
| Total deaths from diseases of the respiratory system | 83,351 | 314 |
| Total deaths from all forms of Cancer | 56,896 | 239 |
| Total deaths from all diseases of the nervous system | 43,740 | 164 |
| Total deaths from all forms of Tuberculosis | 37,990 | 179 |
Cases of Heart Disease of Rheumatic Origin.
The Annual Report of the Chief Medical Officer of the Ministry of Health for 1929 states that
40 per cent. of deaths from heart disease are of rheumatic origin. Acute or Sub-Acute Rheumatism
almost invariably impairs the heart, and in some cases the affection is so acute that death occurs
during the first attack of Rheumatism. 1,417 deaths from Rheumatic Fever in England and Wales,
and 7 deaths from Rheumatic Fever in Willesden probably occurred in such circumstances.
An affection of the heart means impaired efficiency, with the result that the individual so
affected is not able to undertake a normal amount of work, is frequently sick, and ultimately dies
prematurely.
Heart Disease in the manual worker obviously subjects him to greater disabilities on account
of the greater strain put upon his heart than in the case of a man employed in a sedentary occupation.
It is not a practical proposition at the present time to attempt to deal with all forms of Heart
Disease, but good results can be achieved by tackling those cases of Heart Disease which are of
rheumatic origin. The seeds of the heart condition are laid down in rheumatism, which commences
usually in childhood or early adolescence. The child may suffer from growing pains without any