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
Willesden 1931
[Report of the Medical Officer of Health for Willesden]
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degree of acute discomfort; the child may suffer from an acute attack of rheumatism with high
temperature, and tender joints; or the child may have the jerky movements of chorea, i.e., St.
Vitus' Dance.
It is the joint affection which is usually referred to as rheumatism, but it is seldom that an
attack of rheumatism is confined to the joints only. It spreads to the heart, which it may affect
in one way or another, e.g., the lining membrane of the heart may be affected (Endocarditis), or
the heart muscle may be affected (Myocarditis), or the external covering of the heart may be affected
(Pericarditis).
Cases which have once suffered from Rheumatism are very liable to recurrent attacks.
Estimated Number of Heart Cases amongst Willesden School Children.
World-wide investigations during the past 10 years have shewn the extent of the occurrence
of Heart Disease among the rising generation.
The following table is quoted from the Ministry of Health's Report for 1929:—
| Number of School Children Examined. | Percentage of Organic Heart Disease. | |
|---|---|---|
| England and Wales— Board of Education Report, 1924 | 598,167 | 0.7% |
| London— London County Council Report, 1924 | 10,000 | 0.1 % under 5 years |
| 0.25% „ 7 „ | ||
| 0.7 % „ 12 „ | ||
| Glasgow—1924 | 170,000 | Boys 0.8% Age 5 years |
| Girls 0.6% ,, 5 ,, | ||
| Boys 0.8% „ 9 „ | ||
| Girls 0.9% „ 9 „ | ||
| Boys 0.8% „ 13 „ | ||
| Girls 0.7% „ 13 „ | ||
| New York—1918 | 250,000 | 1.6% |
| 1918-22 | 1,336,343 | 1.4% |
| Chicago—1923 | 156,826 | 0.9% |
| 1924 | 153,671 | 1.5% |
| 1925 | 130,266 | 1.7% |
This shows that in city communities children of school age suffer from some definite heart
lesion to the extent of at least 1 per cent. of their number ; and this pretty well corresponds with
the findings of medical inspection in Willesden.
It would accordingly appear that there are at least 200 children attending the elementary
schools in Willesden who are actually suffering from rheumatic heart disease. In dealing with
rheumatic heart conditions the London County Council estimated to have 10,000 cases of heart
disease registered in their school population of some 500,000, or approximately 2 per cent., but this
expectation has been exceeded, 11,000 being registered. On this basis, i.e. 2 per cent., there would be
400 children suffering from rheumatic heart disease in Willesden.
Objects in View.
In considering the setting up of an organisation for dealing with rheumatism and heart disease
the objects in view should be the following:—
(1) The ascertainment of cases.
(2) The diminution of the severity of attacks of rheumatism.
(3) The prevention or mitigation of heart disease in rheumatism.
(4) The prevention of rheumatism.
In the present state of medical knowledge the prevention of rheumatism cannot be assured,
but much can be done by an efficient organisation to ascertain cases of rheumatism and heart disease
and mitigate the ravages of these diseases. It is found, for example, that the intervals between
attacks can be greatly increased by careful supervision, and this result is not only beneficial in itself
but gives good reason for hope in the future.