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APPENDIX II.
INVESTIGATION INTO THE INCIDENCE OF ANEMIA, HEART
CONDITIONS, PALLOR AND RHEUMATISM IN TODDLERS.
By MARGARET EMSLIE, M.B., Ch.B. (Aberdeen).
The number of children examined during the years 1930, 1931 and 1932 was
1,622, and the number of examinations was 2,425.
The following matters were elicited from the investigation:—
A. Anemia.
Four hundred and seventy-eight anaemic children were found. Certain of them
were examined on several occasions and anaemia may have been recorded at one
examination only. On the whole, however, the figures would suggest that some degree
of anaemia occurred in 30 per cent of the cases examined during the pre-school period.
In the separate years the percentage was not quite so high. There was a slight preponderance
of anaemia among the girls, but this was not uniform in each individual
throughout the year. There was no sex preponderance amongst the severe cases.
The degree of anaemia present was recorded clinically in the proportion—276 slight
cases, 187 definite cases and 15 severe cases. The cases of anaemia were grouped as
follows, according to age :—2 years +, 272 cases ; 3 years +, 142 cases ; 4 years +,
64 cases. Comparing these figures with the totals examined at the respective ages, the
age incidence of anaemia is given as follows:— at age 2 +, 23.5 per cent; at age 3 +,
18.6 per cent; at age 4 10.6 per cent. The incidence of anaemia in the cases seen,
therefore, is found to decline steadily from the age of 2 years towards school age.
Seasonal incidence of ancemia. The number of cases of anaemia noticed per quarter
was as follows:— 110, 109, 110, 149: total 478; the number examined each quarter
was:— 497, 670, 584, 674: total 2,425. This gives a percentage of 22.1 and 22.1 for the
two "winter" quarters, as compared with 16.3 and 18.8 for the periods April-June
and July-September. The effect of comparative lack of sunshine is seen more clearly
when the three darkest months (November-January) are compared with the three in
which there is ordinarily a maximum of ultra-violet light (May-July). In the former
case the figure is 23 per cent as compared with 14.7 per cent. This would confirm in
a general way what has been indicated by other workers regarding the concentration of
iron in the blood that takes place under the influence of ultra-violet rays.
The size of family in which the anaemic child was reared (as translatable into overcrowding,
comparative lack of air, poorer dietetic co-efficients for the larger family
units) was observed with a view to discovering whether this played any part in the
production of anaemic conditions. The average size of a " census " family in Woolwich
is 3.6 ; the average size of family found amongst the anaemic cases was :—slight
anaemia, 4.4; moderate anaemia, 4.8; severe anaemia, 4.5. The average for the
anaemic cases, therefore, was slightly higher than for Woolwich as a whole, but not
sufficiently so to allow of any deductions being arrived at.