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
Woolwich 1931
[Report of the Medical Officer of Health for Woolwich]
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104
"Only Children" Cases.— Under 3 years of age. Over 3 years of age.
"Big Interval" Cases.— Where the child observed came at an interval of more
than four years after the birth of the last child.
"Special Circumstances" Cases.— Such as foster children and step-children.
"Replacement" Cases.— Where nervous symptoms were to be associated with the
appearance of a younger child in the family.
"Others."— Including all cases not already recorded; i.e., cases where there was
more than one child in the family and where an interval not greater than
four years had elapsed since the birth of the previous child. This includes
naturally, many cases where replacement occurred, as it does in the
"ordinary" family without symptoms, i.e., cases where children were
born at shortish intervals but where the division of attention was not sudden
or such as to produce a particular sense of loss in any one individual.
The "Replacement" group, it may be said, was differentiated solely for the
interest of the observer, who was anxious to determine the type of
symptoms evidenced in certain circumstances, when a re-action was
present, and when this was at the same time open to clear differentiation
from other re-actions examined. Its size is no indication of the numbers
of cases examined in which replacement was not accompanied by
untoward effect, or where it was open to be confounded with other
factors, and has, therefore, no bearing on the symptoms or lack of
symptoms shown by the young child growing up as a member of a
rapidly increasing family, which some would call the aggravated condition
of " replacement."
The following Table shows the total cases grouped according to the classifications mentioned above:—
Table II.
| District. | Only Children | Big Interval Children. | Replacement cases with symptoms. | Special Cases. | Others. | Total. | |
|---|---|---|---|---|---|---|---|
| Under 3 | Over 3 | ||||||
| Town Hall | 80 | 45 | 41 | 38 | 5 | 158 | 367 |
| Eltham | 48 | 34 | 53 | 29 | 7 | 329 | 500 |
| Plumstead | 21 | 16 | 17 | 13 | 3 | 39 | 109 |
| New Eltham | 40 | 18 | 9 | 15 | - | 40 | 122 |
| 189 | 113 | 120 | 95 | 15 | 566 | 1,098 | |
The type of symptoms seen was classified as follows:—
Thumb-sucking.
Enuresis.
Temper; fright on examination; general shyness; nervousness.
Depression, "misery," noticed at home.
Backwardness (generally in speech, sometimes habits).
Over-dependence on mother; mother anxiety.
Sleep difficulties (refusal to go to bed, wakefulness, night terrors, persistent desire
to sleep with parents, etc.).
Child still on breast, bottle or dummy over the age of 2 years.
Frank mismanagement as seen at examination (obvious spoiling, threatening,
deceiving, spanking, etc.).
Lack of appetite, vomiting attacks, constipation—the "acidosis" syndrome.
Stammering, stuttering.
"Bad habits," self-abuse.