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f6162443-7ced-4b16-a0d4-5bedcd9d00a0 | Some of the causes of neo-natal deaths are known and theoretically preventable. One of these is difficult delivery- with consequent damage to the infant. There were 3 deaths from intracranial haemorrhage, and 1 from injury at birth, but these 4 occurred in maternity hospitals where, presumably, the actual delivery took place under the best possible conditions, and where the best skill was available. The two deaths from Mongolism and Spina Bifida were due to developmental faults, and also the death from congenital heart disease, though probably the latter was neither congenital nor 77 disease, but due to persistence of the normal heart after the placental circulation is abolished. The highest number of neo-natal deaths is attributed to prematurity; 9 deaths were assigned to this cause. Prematurity of itself does not prevent survival; though premature infants are more difficult to rear, many are successfully reared and develop into healthy, normal children. But the causes of prematurity are not clear. |
b009e7fe-381a-4b83-b995-6c06d5e8faa9 | Some suggest that lack of vitamin E plays an important part, and any failure of the nutrition of the embryo will destroy its vitality. At one time syphilis was supposed to be the cause of many premature births, and some ante-natal clinics adopted the practice of making a Wassermann test an essential part of ante-natal supervision, but most clinics have discarded this. Syphilis is not now regarded as a common cause of prematurity, and prematurity is not more common in poorly fed and sickly mothers than it is in those who are well cared for and healthy. V Altogether 23 deaths occurred in infants under 4 weeks old, compared with 29 in 1935. In the period between 1 and 12 months the most fatal causes were diarrhoea and pneumonia, and it is difficult to explain the higher incidence of death from these two diseases. In neither case could climatic conditions be blamed for the winter months of the year were not extremely cold nor were the summer months abnormally hot and dry. |
1a0d1dc9-85f1-4623-a795-194f9c9fd5f9 | Toddlers. In last year's report a full account was given of the work done among Toddlers. Last year Circular 1550 was issued which urged upon Local Authorities the extension of arrangements made by them for the supervision of the health of children not in attendance at school. This Circular was considered by the Child Welfare Committee and it was decided to establish a Special Toddlers Clinic as an experiment at the Steele Road Centre. The Centre is held on Friday afternoons and Dr. Mann attends once a month. Dr. Mann carries out a modified medical examination on the lines set out in the School Medical Schedule. The establishment of this Clinic has been a success, but there are difficulties of staff and accommodation which prevent the establishment of similar Clinics at the other centres at the present time. 78 Maternal Mortality. There were two deaths which are reckoned as maternal mortalitythe causes being prolonged labour in one case and septicaemia following abortion in the other. |
eb4399c7-9d22-40ef-9085-498c6049fb22 | There was a third death connected with pregnancy, but as the cause of death was given as a pelvic abscess following self-induced abortion, the death is reckoned as suicide, and not puerperal sepsis. This case naturally had not called in a doctor until she was seriously ill. From one point of view the third death is of as much importance as the other two maternal deaths, though prevention is not so easily applied. The home conditions were poor and there were 4 other children. She had had another abortion about 6 years previously. There is no doubt that she dreaded the prospect of another child on account of poverty. The death from prolonged labour occurred in a nursing home and the doctor in attendance was assisted by a midwifery specialist. The death from pelvic abscess following abortion occurred in a Maternity hospital. She was admitted to the hospital as a possible acute appendix. In the hospital she was found to be suffering from Pyelitis of pregnancy. |
ccb40992-a13d-4f3e-a92d-7cfdfb73f397 | Two days after admission she aborted, and two days later death occurred. In both these cases the highest skilled ante-natal care and natal care were available, and it is difficult to see under what condition the deaths could have been prevented. In previous reports an account has been given of the agreement with the Middlesex County Council for the admission of cases into the Central Middlesex County Hospital. In 1931 arrangements were made for the admission of cases into the hospital. Our scheme was for the admission of those mothers who were not necessitous, but who could not afford the full nursing home fees. |
261d54d8-e5f0-48c7-89e7-0431af0b44e6 | The scheme was a success from the beginning, and to its termination in 1936 the number of women who applied for admission steadily increased as the folllowing figures show: Number of cases admitted during 1931 50 „ „ „ „ 1932 122 „ „ „ „ 1933 149 „ „ „ „ 1934 209 „ „ „ „ 1935 270 „ „ „ „ Jan/June 1936 205 79 Owing to the increase of population in West Middlesex the maternity accommodation at the disposal of the County Council became overtaxed, and it soon became obvious that our scheme was in danger. The appointment of a lady almoner was the beginning of the end. The duties of the almoner were, of course, to select the cases for The appointment of a lady almoner was the beginning of the end. admission, and in view of the pressure it was natural that those whose home conditions were satisfactory would be refused when the accommodation was limited. |
355f1312-0035-419c-841f-f686cc711e55 | As our scheme was primarily conceived for non-necessitous cases we frequently accepted cases where the accommodation at the home might be considered suitable for the confinement, and these cases were refused by the lady almoner. There were other factors which operated. On the 1st April, 1936, the County Council's general hospitals were appropriated under the Public Health Acts, and the chief reason for the existence of the agreement disappeared. The County Council held the view that it was inequitable that those District Councils which bad subscribed to the Agreements should continue to be financially liable for the cost of maintenance of cases from their area, whilst at the same time through the General County Rate contributing their quota to the cost of the County Council's maternity beds as a whole. In June, 1936, the Agreement practically came to an end although no formal notice was given by either side of its termination. The Central Middlesex County Hospital still receives cases from Acton, but not under a scheme of the local Council. Day Nursery. |
2d739731-6eb9-4f09-9a18-ebf94415cb89 | The Nursery is situated in Bollo Bridge Road, and is open on five days a week. The Nursery was open on 212 occasions, and 5,250 wholeday attendances were made. Child Welfare Centres. Eight sessions are held weekly-4 in Avenue Road, 2 in Steele Road Mission, and 1 each at John Perryn School and St. Gabriel's Hall. Nurse Children. At the end of the year 1935, there were 39 children and at the end of the year 1936, there were 39 children on the register. 80 FOSTER CHILDREN. No. as at 31st. Doc. 1935. Notice of Recoption of Children during 1936. NOTICE OF REMOVAL TO : Children Adopted Died. Children reached ago of 9 No. as at 31st.Dec. 1936. Parents. Another area with Foster Parent. |
0899b57a-8c09-4461-be95-e44c7627215b | Another Foster Mothor Publia lnstitutution or Home. Other eausos. 39 16 5 3 1 2 - 2 1 2 39 FOSTER MOTHERS. No. as at 31st Dec., 1935. Application for Registration during 1935. Removed to another Area with child. No longer a Foster Mother. No. as at 31st. Dec., 1936 30 11 3 9 35 TABLE I. BIRTH-RATE, DEATH-RATE, AND ANALYSIS OF MORTALITY DUR1NG THE YEAR 1030. The Mortality rates for England and Wales refer to the whole population, but for London and the towns to civilians only. Rate per 1,000 Total Population. Annual Death-Rate per 1,000 Population. Rate per 1,000 Live Births Live Births. Still-births. |
da82d9b6-95a6-4225-8b2a-91fa22b631a9 | All Causes. Enteric Fever. Small-pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Violence. Diarrhoea and Enteritis (under two years). Total Deaths under one year. England and Wales 14.8 0.61 12.1 0.01 0.00 0.07 0.01 0.05 0.07 0.14 0.52 5.9 50 122 County Boroughs and Great Towns, including London 14.0 0.67 12.3 0.01 0.00 0.00 0.01 0.06 0.08 0.14 0.45 8.2 63 143 Smaller Towns Estimated Populations, 25,00050,000) 15.0 0.64 11.5 0. |
d7dc384c-5ed4-4488-9589-bd80e4950b68 | 00 0.00 0.04 0.01 0.04 0.05 0.15 0.39 3.4 55 London 13.0 0.53 12.5 0.01 0.00 0.14 0.01 0.06 0.05 0.14 0.52 14.4 60 Acton 12.7 0.4 11.5 0.00 0.00 0.14 0.00 0.00 0.01 0.1 0.43 13.6 68 The maternal mortality rates for England and Wales are as follows:- Puerperal Sepsis. Others. Total. per 1,000 Total Births 1.34 2.31 3.65 „ „ „ „ (Acton) 1.13 1.13 2.26 82 TABLE II. |
a7f72b8e-6148-41af-9491-4af7c2fd34f4 | VITAL STATISTICS FOR THE WHOLE DISTRICT DURING 1936 AND PREVIOUS YEARS. Year Population estimated to Middle of each Year. Births Total Deaths Registered in the District Transferable Deaths Nett Deaths belonging to the District Nett Under 1 year of Age At all Ages Number Rate Number Rate of Non-Resideants Registered in the District of Residents Registered outside Dist. Number Rate per 1,000 Births Number Rate per 1,000 inhabitants 1927 66,700 1026 15.60 445 6.67 21 280 62 60 704 10.55 1928 67,645 1003 14.83 479 7.08 29 244 55 55 694 10.26 1929 68,600 1026 14.96 540 7.87 21 307 85 83 826 12.04 1930 69,565 1105 15. |
6000622c-1157-44b9-971d-e9096f135ed9 | 88 440 6.33 31 284 56 50 693 9.96 1931 70,560 1018 14.43 456 6.46 35 321 62 61 742 10.52 1932 70,640 970 13.70 486 6.88 29 302 60 62 786 11.11 1933 70,300 886 12.60 492 6.99 31 329 41 46 788 11.20 1934 69,472 943 13.57 454 6.50 24 297 39 41 727 10.46 1936 68,960 868 12.60 417 6.04 41 328 51 60 704 10.20 1936 69,140 881 12.7 431 6. |
a88bb726-7dfd-41c7-9889-75053aafa288 | 2 42 405 60 68 794 11.5 83 TABLE III. AGES AT DEATH. AND WARD DISTRIBUTION Causes of Death. Age in Years. Ward Distribution. All ages Under 1 year 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and up wards North East. North West. South East. South West. |
80eb8b24-07f7-47dd-b3f3-2114ccb76069 | Measles 10 2 7 1 - - - - - 2 3 2 3 Diphtheria 2 - - 1 1 - - - - 1 - - 1 Influenza 7 - - - - 1 1 1 4 2 3 4 - Phthisis 47 - - - - 8 23 13 3 14 12 3 18 Other forms of Tuberculosis 4 - - - 1 2 1 - - 1 1 1 1 G.P.1. & Tabes Dorsalis 1 - - - - - 1 - - 1 - - - Cancer 112 - - - - 1 9 50 52 37 33 23 19 Diabetes 9 - - - - - 3 3 3 3 3 2 1 Cerebral Haemorrhage, &c. 62 - - - - - - |
8e0b3a11-3efd-45d1-bf16-8f7d22398820 | 15 47 17 17 12 16 Heart Disease 168 - - - 2 1 12 60 93 45 47 32 44 Other Circulatory Diseases 12 - - - - - 1 3 8 4 2 3 3 Bronchitis 44 1 - - - - 2 12 29 19 5 8 12 Pneumonia 65 10 - 2 1 1 1 27 23 14 22 10 19 Other Respiratory Diseases 9 1 - - - - 2 4 2 4 1 3 1 Peptic Ulcer 8 - - - - - 2 3 3 1 1 3 3 Diarrhoea 12 12 - - - - - - - 4 2 - 7 Appendicitis 4 1 - - 1 - - - 2 1 1 1 1 |
ba1ac9de-bb18-4937-882a-c75e575768a6 | Cirrhosis of Liver 4 - - - - - 2 2 - 4 - - - Other diseases of Liver 2 - - - - - - - 2 2 -- - - Other Digestive Diseases 1 - - - - - - 1 - - - 1 - Nephritis 21 - - - - 2 3 6 10 8 6 1 - Puerperal Sepsis 1 - - - - - 1 - - - 1 - - Other diseases, &c. of Parturition 1 - - - - - 1 - - - - 1 - Congenital debility, Prematurity, &C. |
4674351a-f400-4d75-a437-ff1d2973998e | 27 27 - - - - - - - 10 9 3 5 Senility 75 - - - - - - - 75 20 23 12 20 Suicide 10 - - - - - 3 3 4 3 4 1 2 Other deaths from violence 20 - 1 - 2 2 3 10 2 5 9 1 5 Other defined diseases 56 6 1 2 3 4 9 17 14 17 14 9 16 TOTALS 794 60 9 6 11 22 80 230 375 239 218 138 199 84 TABLE IV INFANTILE MORTALITY, 1930. Causes of Death. Ages. Wards. Total Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks 1-3 months 3-6 | months 6-9 months. |
0096eb3d-5085-435b-8ee9-a21fbba2003f | 9-12 months North East North West South East South West Measles 2 - - - - - - 2 - - - 1 1 Congestion of I.ungs 1 - - - - - 1 - - - - 1 - Pneumonia 10 1 - 1 - 2 2 2 2 2 3 - 4 Diarrhoea 12 - - - - 1 7 1 3 4 1 - 7 Prematurity 9 8 - - - 1 - - - 3 3 2 1 Appendicitis 1 - - - - - - 1 - 1 - - - Congenital Heart Disease 1 - - 1 - - - - - - 1 - - Spina Bifida 1 - - - - 1 - - - 1 - - - StatuoLymphaticuo 1 - - - - 1 - - 1 - - - Marasmus 3 - |
622bc931-92d9-459f-a18e-5eb2dfdd61b9 | - - - 1 1 1 - 1 - - 2 Injury at birth 1 - 1 - - - - - - - 1 - - Convulsions 3 - - - - 1 2 - - - 1 - 2 Mongolism 1 - - - - - 1 - - 1 - - - Malnutrition 1 - - - - - - - - - - - 1 Otitis Media 1 - - - - - - 1 - 1 - - - Inattention at Birth 1 1 - - - - - - - - 1 - - Bronchitis 1 1 - - - - - - - 1 - - - Intraeranial Haernorrhage 6 5 - 1 - - - - - 3 1 - 2 Atelectasis 3 3 - - - - - - - 1 1 1 - Pyelonephritis 1 - - - - - 1 |
7bd6af47-f71f-4b48-b456-e41caaf2804c | - - - - 1 - TOTALS 60 19 1 3 - 9 15 8 5 20 30 7 20 85 TABLE V. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR, 1930. Notifiable Disease. Cases notified in whole District. At Ages—Years. Ward Distribution. At all Ages under 1 1 to 5 5 to 15 1ft to 25 25 to 45 46 to 65 Over 65 North East North West South East South West Scarlet Fever 177 1 58 94 10 12 2 - 52 75 27 23 Diphtheria 12 — 6 4 1 - 1 - 4 3 1 4 Pneumonia 35 1 8 2 7 7 10 - 4 10 13 8 Erysipelas 17 — — - 1 |
f64194da-eee0-4890-975b-62d06c0ae3a3 | 6 7 3 4 7 1 5 Puerperal Pyrexia 6 — — - 1 4 1 - 3 1 — 2 Ophthalmia Neonatorum 2 2 - - - - - - - - 1 1 Paratyphoid 1 - - 1 - - - - - - - - Poliomyelitis 1 — — 1 - - - - - 1 - - Tuberculosis (resp.) 89 — 1 2 34 36 13 3 25 30 12 22 Tuberculosis (other) 15 — — 2 7 2 3 1 4 2 2 7 TOTALS 355 4 73 106 61 67 37 7 97 129 1 57 72 86 OPHTHALMIA NEONATORUM. Cases. Vision unimpaired. Vision impaired. Total Blindness. |
110346cd-459a-4cf8-bf25-7294b0069a26 | Deaths. Notified. Treated. At home. In hospital. 2 1 1 2 — — — 87 CASES REMOVED TO HOSPITAL. TABLE 6. Total Notified. Scarlet Fever 156 177 Diphtheria 12 12 Pneumonia 19 35 Puerperal Pyrexia 2 6 Erysipelas 4 17 Ophthalmia Neonatorum 1 2 Paratyphoid 1 1 Poliomyelitis - 1 TABLE 7. BIRTHS. Male Female. Total. Live Births. Total 464 417 881 Legitimate 453 392 845 Illegitimate 11 25 36 Still Births. Total 16 13 29 Legitimate 14 12 26 Illegitimate 2 1 3 Notified Live Births. Ward Distribution. |
b71e276f-788b-4bf5-91eb-05e607fa5d1d | Total Births notified in the district Total. N. East. N. West. S. East. S. West. 388 124 93 52 119 Notifications received from other districts 437 148 121 56 112 Notified Still Births Inside 6 Outside 12 Total 18 Notifications were received from : Doctors and Parents 670 Midwives 173 Table 8. INFANT WELFARE CENTRES, 1936. |
cc92c3c6-acd1-48c4-825d-43e51fa9571d | Number of Centres provided and maintained by the Council 4 Total number of attendances at all centres during the year:— (a) by children under 1 year of age 10,650 (b) by children between 1 and 5 years of age 7,737 88 Average attendance of children per session 50 Number of children who attended for the first time during the year:- (a) under 1 year of age 594 (b) between 1 and 5 years of age 209 Percentage of notified live births represented by number of children who attended a centre for the first time during the year 72% Children treated at Dental Clinic 135 Children treated at Ophthalmic Clinic 10 Mothers treated at Ophthalmic Clinic - Children operated on for enlarged tonsils and adenoids 2 Children operated on with X-Ray for Ringworm - TABLE 9. ANTE-NATAL CLINIC. |
9f568f4e-1e9c-4392-a67a-60e1d6882482 | Number of Expectant Mothers who attended 249 Number of attendances made by Expectant Mothers 283 Mothers referred for Dental treatment at the Clinic 90 Mothers supplied with Dentures 34 Expectant Mothers to whom Dried Milk was supplied free 72 Number of packets of Dried Milk supplied free 1186 TABLE 10. INQUESTS. Inquests30. Struck by motor car 10 Collision on railway 1 Suicide 10 Knocked down by train 1 Accidental fall 1 Accidental burns 1 Struck by motor cycle 1 Post traumatic epilepsy 1 Fall from motor cycle 1 Septicaemia after teeth extraction 1 Injuries by laundry machinery 1 Fall from train 1 Coroner's Certificate after Post Mortem without an Inquest-31. |
4d2237ac-637b-476a-9456-4ab02198e8b7 | Heart Disease 16 Pulmonary Congestion 2 Cerebral Haemorrhage 4 Phthisis 1 Convulsions 3 Cancer 1 Nephritis 2 Inattention at birth 1 Cirrhosis of Liver 4 89 FACTORIES, WORKSHOPS AND WORKPLACES. 1.- Inspection of Factories, Workshops and Workplaces including Inspections made by Sanitary Inspectors. Premises. Inspections Written Notices (1) (2) (3) Factories 75 18 (Including Factory Laundries) Workshops 368 5 (Including Workshop Laundries) Workplaces 9 Nil (Other than Outworkers' Premises) Total 452 23 2.—Defects found in Factories, Workshops and Workplaces. Nuisances under the Public Health Acts:— Particulars. |
2f78d1c5-f750-48cd-b86d-f2f218f5415a | Found Remedied (1) (2) (3) Want of Cleanliness 23 23 Want of Ventilation Nil Nil Overcrowding Nil Nil Want of drainage of Floors 1 1 Other Nuisances 5 5 Sanitary Accommodation:— Insufficient 7 7 Unsuitable or defective 29 29 Not separate for sexes Nil Nil Offences under the Factory and Workshop Acts:— Illegal Occupation of underground Bakehouses Nil Nil Other offences Nil Nil Total 65 65 3.—Outwork in unwholesome premises, Section 108 Nil 90 STAFF. D. J. Thomas, m.r.c.s., l.r.c.p., d.p.h., Medical Officer of Health (Medical Superintendent of the Isolation Hospital and School Medical Officer). Elsie Madeley, m.b., Ch.b., d.p.h., Assistant Medical Officer of Health and School Medical Officer. P. H. Slater, l.d.s., School Dentist. |
8a48c88e-c36f-4ee0-9ab6-1a7e5586f65f | M. W. Kinch, M.R.San.I., Cert, of Royal Sanitary Institute ; holds Meat and Smoke Certificates; Chief Sanitary Inspector (Inspector under Diseases of Animals Acts and the Rag Flock Act). J. J. Jenkins, Cert. of Royal Sanitary Institute; holds Meat and Smoke Certificates, Deputy Chief Sanitary Inspector (Inspector under Fabrics Misdescription Act). E. W. Brooks, Cert. of Royal Sanitary Institute, Sanitary Inspector. J. J. Matthews, Cert. of Royal Sanitary Institute; holds Meat Certificate, Sanitary Inspector. A. H. G. Johnson, Cert. of Royal Sanitary Institute; holds Meat Certificate; Meat Inspector. (Appointed 1st June, 1936). Miss A. M. Cooksey, A.R.San.I., Certificate of Royal Sanitary Institute, Health Visitor. Miss J. Welsh, Certificate of Royal Sanitary Institute, c.m.b., Health Visitor. |
74c2e6fa-940e-44e6-ae03-871668903686 | (Died 16/8/1936) Miss B. G. Sorlie, s.r.n., Certificate of Royal Sanitary Institute, c.m.b., H.V. Diploma, Health Visitor and School Nurse. Miss A. Woosnam, s.r.n., c.m.b., Health Visitor and School Nurse. Miss M. I. Greenwood, s.r.n., Certificate of Royal Sanitary Institute, c.m.b., Health Visitor and School Nurse. H.L. Hacker,* Chief Clerk. 91 Miss V. E. Arnold* Clerk. Miss D. E. Beacon. Clerk. Miss A. Kent* Clerk. Miss V. Slack* Clerk. Miss J. Wood* Clerk. Miss M. J. Gilfillan,* s.r.n., c.m.b., Matron, Isolation Hospital. Miss F. A. Cavendish, Matron, Day Nursery. G. Baker,* Disinfector. |
cbdb75c9-3af6-4bb4-89e1-30f12a403e7f | A. C. Mepham,* Assistant to Meat Inspector and Mortuary Keeper. Note.—To the salaries of all the above officials excepting those marked with an asterisk, contribution is made under the Local Government Act, 1929. I wish once again to express my appreciation and thanks to all the members of my staff for their excellent co-operation during the year. I am, Your obedient Servant, D. J. THOMAS, Medical Officer of Health. 93 ANNUAL REPORT OF THE School Medical Officer FOR THE YEAR 1936. Municipal Offices, Acton, W.3. To the Chairman and Members of the Acton Education Committee. Ladies and Gentlemen, We beg to submit the following report upon the schools and school children of Acton for the year 1936. As in former years the subject matter has been arranged as far as possible in tabular form. The tables at the end of the report are those issued by the Board of Education. |
e58db7b9-8332-4afd-a35c-29089489a3cb | In 1936 the general health of the school children was satisfactory. There was practically no Diphtheria, and Scarlet Fever was confined in large measure to one area in the town. The outstanding feature of medical interest and anxiety was the increase in the cases of Rheumatism among our school children. This disease is not only dangerous during the acute stage, but leaves such a train of ill effects behind it that at the best the child has to be kept under supervision for the remainder of its school days. Often the child has to be sent to a special school or Heart Home for a time, if not for the remainder of its school life. The reason for the increase in cases is difficult to find, but an article on Rheumatism and its causes, &c., will be found in the report. 94 Another puzzling feature of the year 1936 was an outbreak of Scabies. |
bea99149-fe51-4f13-be78-bd56f33cc4e8 | This was not confined to the Borough of Acton as was evidenced by the fact that our usual arrangements for dealing with these cases broke down under the strain of patients sent for treatment from other sources, and new arrangements had to be made. Details of the cases are given in an article in the report. The drains and sanitary conveniences at all the schools have been periodically inspected by the Sanitary Inspector. In 3 of the schools all the drains and sanitary* fittings were satisfactory. In the others, certain minor defects were noted and a copy of the full report has been sent to the Director of Education, and the matters will have the attention of the Education Committee at an early date. PUBLIC ELEMENTARY SCHOOLS WITHIN THE DISTRICT WITH ACCOMMODATION. Name of School. Dept. Accommodation. Avge. monthly No. on Registers Average attendance Acton Wells Senior 320 232 214 Junior 364 413 377 Infants' 364 384 302 Beaumont Park Senior |
2534751a-057d-4f85-a53e-88dc092dfe20 | Girls' 450 163 148 Junior Girls' 450 213 198 Infants' 400 219 179 Berrymede Junior Boys' 640 433 384 Junior Girls' 542 381 342 Infants' 450 292 242 Central 480 420 390 Derwentwater Junior 441 381 351 Infants' 350 302 239 John Perryn Senior 360 219 199 Junior 288 266 244 Infants' 336 280 240 Priory Senior Boys' 500 299 270 Senior Girls' 499 337 287 Infants' 400 265 219 Rothschild Junior Boys' 450 210 190 Infants' 400 262 212 Southfield Senior Boys' 415 169 157 Junior Mixed 382 318 289 Infants' 350 266 206 Turnham Green R.C. Mixed 327 327 202 Special (M.D.) |
1b18c661-4e62-41f5-a823-8475de4684e6 | 68 42 33 10026 7009 6114 95 average HEIGHT without shoes and AVERAGE WEIGHT without clothes. Anthropometric Committee, 1929. MALES. FEMALES. Age last birthday. Height in Weight in Height in Weight in ins. lbs. ins. lbs. 3 36.9 32.9 36.6 31.5 4 39.2 35.9 38.4 33.7 5 41.4 38.7 41.1 37.5 6 43. 41.3 42.8 40.1 7 45.4 45.4 45.1 44.1 8 47.8 51. |
a921dcb3-3b0b-4656-9e65-a6abd06756aa | 47.5 49.4 9 49.2 54.8 48.9 52.6 10 51.3 59.6 51.2 59.8 11 52.7 64.6 52.8 63.9 12 55. 71.6 55.6 73.9 13 56.2 76.5 56.9 79. 14 58. 86.1 58.9 88.2 15 61.8 99.3 62.3 106.8 TABLE SHOWING HEIGHTS AND WEIGHTS AT DIFFERENT AGES LEAVERS (BOYS) No. Examined. Years of Age. 12—13 13—14 14—15 No. Height ins. Weight lbs. No. Height ins. Weight lbs. _No. Height ins. Weight lbs. |
454d5a02-0a6a-4e01-8521-47421c7707bd | Acton Wells Senior 47 47 57.3 84.2 ... ... ... ... ... ... Central 47 47 58.3 83.6 ... ... ... ... ... ... John Perryn Senior 38 36 58.4 79.9 2 62.7 99.2 ... ... ... Priory 111 110 57.6 81.4 1 56.3 72.8 ... ... ... Southfield Snr.Boys' 66 64 57.1 80.4 2 60.5 97.6 ... ... ... Roman Catholic 10 9 56.6 81.1 1 62.3 91.8 ... ... ... 319 313 6 ... (GIRLS) Acton Wells Snr. 51 49 57.6 78.9 2 60.6 91.2 ... ... ... Beaum't Pk. Snr. |
8becaf48-fa6f-4669-9628-ad80c3fdd1f6 | 68 68 58.6 86.2 ... ... ... ... ... ... Central 60 60 59.1 86.8 ... ... ... ... ... ... John Perryn Snr. 38 38 59 82.6 ... ... ... ... ... ... Priory 110 106 58.3 77.4 4 60.1 85.4 ... ... ... Roman Catholic 9 7 62.6 97.5 2 62 100 ... ... ... 336 328 8 96 TABLE SHOWING HEIGHTS AND WEIGHTS AT DIFFERENT AGES. INTERMEDIATES (BOYS) No. Examined. Years of Age. 7—8 8—9 9—10 No. Height ins. Weight lbs. No. Height ins. Weight lbs. No. Height ins. Weight lbs. |
e12e433c-662d-402b-8057-171c439c0fdb | Acton Wells Junior 18 12 48.9 53.9 6 50.1 57 ... ... ... Acton Wells Infts.' 37 26 48.8 53.9 11 49.6 55.5 ... ... ... Beaumont Pk. Infts.' 4 4 46 49.3 ... ... ... ...... ... ... Berrymede Jnr. Boys 94 53 49.3 55.8 41 49.4 55.7 ... ... ... Berrymede Infants' 2 2 48 53.1 ... ... ... ... ... ... Derwent water Jnr. 45 29 49.2 55.9 12 50.7 57.9 4 52.6 66.7 Derwentwater Infts.' 1 1 48 52 ... ... ... ... ... ... John Perryn Infts. |
c184d03b-909f-4579-872a-f0e036bf241b | 43 20 49.4 52.8 23 50.2 55.5 ... ... ... Priory Infants' 9 9 47.9 50.8 ... ... ... ... ... ... Rothschild Junior 42 12 49.5 55.3 30 49 54.3 ... ... ... Rothschild Infants' 3 3 48.6 51.5 ... ... ... ... ... ... Southfield J unior 32 12 48.9 53.7 20 49.6 55.9 ... ... ... Southfield Infants' 4 4 49.2 54.3 ... ... ... ... ... ... Roman Catholic 11 5 48.2 52.2 6 50.1 53.4 ... ... ... 345 192 149 4 TABLE SHOWING HEIGHTS AND WEIGHTS AT DIFFERENT AGES INTERMEDIATES (GIRLS) No. Examined. |
c2dbc976-e2b8-4c22-98df-b7f543a0b00b | Years of Age. 7—8 8—9 9—10 No. Height ins. Weight lbs. No. Height ins. Weight lbs. No. Height ins. Weight lbs. Acton Wells Junior 18 14 49.5 56.4 4 50.4 57.2 ... ... ... Acton Wells Infants' 44 29 48.7 54.2 15 49.1 54.2 ... ... ... Beaumont Park Jnr. 45 21 48.8 52.8 23 48.9 53.4 1 50.5 49 Beaumont Park Infts. 2 2 48.4 50.4 ... ... ... ... ... ... Berrymede Jnr. 79 49 48.6 52.9 30 49.3 56.3 ... ... ... Berrymede Infts. |
a017e303-f9ff-464e-8e84-df317154b58f | 5 5 47.3 50.2 ... ... ... ... ... ... Derwentwater Jnr. 45 24 49.1 58.9 16 50.2 58.6 5 50.9 59.2 Derwentwater Infts.' 5 5 46.9 49.1 ... ... ... ... ... ... John Perryn Jnr. 1 ... ... ... 1 51.3 61 ... ... ... John Perrvn Infts.' |
8dd3fcf4-61aa-423f-a876-357c82bbe7c9 | 42 23 48.8 51.1 19 48.8 51.6 ... ... ... Priory Infants' 5 5 48.1 51.8 ... ... ... ... ... ... Rothschild Infants' 4 4 48.5 50.4 ... ... ... ... ... ... Southfield Junior 34 17 49.1 55.5 17 48.9 55.2 ... ... ... Southfield Infants' 2 2 47.9 44.2 ... ... ... ... ... ... Roman Catholic 18 6 49.1 56.2 7 48.8 52.4 5 52.2 57.5 349 206 132 ... ... 11 ... ... TABLE SHOWING HEIGHTS AND WEIGHTS AT DIFFERENT AGES. ENTRANTS (BOYS) No. Examined. Years of Age. |
a9789175-e53a-45ac-b36f-56476d8f08fe | 3-4 4-5 5-6 6-7 No. Height ins. Weight lbs. No. Height ins. Weight lbs. No. Height ins. Weight lbs. No. Height No. Weight lbs. Acton Wells Infants' 66 . 31 41.4 38.2 32 43.8 42.7 3 45.9 51 Beaumont Park Infanta' 32 14 37.1 33.7 6 40.1 38.6 8 42.7 42.3 4 44.9 46.5 Berrymede Infants' 49 19 37.1 33.6 12 39.4 36.8 14 42.5 41.1 4 46.3 49.1 Derwentwater Infants' 73 . . . 20 41. |
df7a649a-6a50-4057-9599-c26867cd8dec | 7 40 36 43.9 44.7 11 46.8 49.8 John Perryn Infants' 36 . . . 10 40.8 38.9 17 44.1 44.3 3 41.8 51.1 Priory Infants' 67 12 37.9 30.5 25 40.2 39.7 27 42.9 43.2 3 45.2 48.3 Rothschild Infants' 56 17 37.9 34.6 20 40.6 39.7 16 42.9 40.7 3 46.5 50.8 Southfield Infants' 58 . . . 19 41.2 39.6 33 43.8 43.9 6 46.3 49.8 Roman Catholic 16 . . . 9 41.2 38. |
60505674-25c4-4058-be55-d952714feb89 | 4 5 44.4 45.4 2 46.9 52.6 453 62 164 188 39 (GIRLS) Act-on Wells Infants' 52 . . . 24 41 37.6 20 46.5 42.3 8 45.2 45.2 Beaumont Park Infants' 37 11 37 33.3 13 40.3 38 8 40.8 37.4 5 45.3 49 Berrymede Infants' 40 14 37.1 33.3 11 39.6 36.5 8 422.4 41.2 7 45 46.5 Derwentwator Infants' 70 . . . 30 40.8 39 34 43.7 43 6 45.1 46.8 John Perryn Infants' 27 . . . |
a3d1ac49-cd91-447b-933e-76755409ad02 | 6 40.3 36.2 16 43.4 42.1 5 45.8 46.8 Priory Infants' 52 9 37.3 33.4 21 40 37.1 15 42.9 40.4 7 46 46.6 Rothschild Infants' 42 13 37.1 32.9 8 40.9 37.8 18 42.7 41.1 3 43.6 41.3 Southfield Infants' 52 . . . 15 1.1 39.3 26 43 40.5 11 45.5 46 Roman Catholic 11 . . . 4 42.5 41.6 4 44.6 44.6 3 44.6 42.9 383 47 132 149 55 98 RHEUMATISM. |
ace5097f-c290-496f-801d-02d35921aed0 | Acute Rheumatism is a disease of childhood and youth whose effects persist to adult life and is the cause of much of the heart disease met with in adolescence and later in life. It was first named and described some 4 centuries ago by Baillon and referred to by Sydenham in the 17th century as attacking the young and vigorous. It was not however, until well into the 19th century that the disease found a place of any importance in the books on diseases of children and not until the 20th century were attempts on any large scale made to use the knowledge gained to avert or alleviate the condition. Much work was done by many clinicians, pathologists and bacteriologists on the causation and course of the disease in the latter part of the 19th century and up to the present day work is still being eagerly carried out. Many theories have been put forward, discarded, amended, and even now the cause of rheumatism in childhood is the subject of much research. |
75aa8186-4e66-4033-ac51-8bc420460254 | The association of Rheumatism with heart disease was first pointed out in 1778 and with the invention of the stethoscope in 1816 the association was established. In 1809 the connection between Chorea and Rheumatism was first noted and the observation was confirmed in 1821 by Copeland. Later, in 1847, the connection was beginning to be acknowledged and by 1870 it was generally accepted. During the present century increasing interest has been taken in this subject and it has been realised that if heart disease is to be attacked in the adult population, prevention must be practised among children. From 1920-1924 investigations in London and Glasgow were carried out, and the results published by the Medical Research Council, and between 1920-1927 the British Medical Association held meetings and published reports on " The care of the rheumatic child " and Sir George Newman prepared a special report on " Acute Rheumatism in children and its relation to heart disease'.' |
7573d072-1f83-4d0a-bc38-29b6ceebd802 | F. J. Poynton was one of the most earnest workers on the cause, care and treatment of rheumatism in childhood, and as far back as 1912 he was saying that "special convalescent homes will be the means of averting much of the chronic heart disease of rheumatic origin that ruins so many lives and is the despair of the physician and our general hospitals." Unfortunately Dr. Poynton was not listened to and it was left to America to show us the way when they established special cardiac clinics for the control and care of children suffering from rheumatism but not ill in hospital. 99 It was the Invalid Children's Aid Association in this country which took the first step in dealing with rheumatism in childhood and now no country has a better organisation than this. A special convalescent home gives the child's heart the best chance of recovery in the best circumstances. |
35c0aecc-52b1-4700-bb42-918e79c9827c | If the child is left in its own home where the other children have no disability, where the mother is overworked and has no time to see that the affected heart is not being overstrained, or where overanxiety leads to the insistence that the child does nothing at all, where is the chance of improvement compared with regulation of life, exercise, and education found at these special convalescent homes? It has been said that ideally, every child whose heart has been affected by rheumatism should spend from 12-18 months afterwards at these special homes to lessen the chance of a recurrence. Most acute rheumatism occurs in poor rather than rich homes. It is not unknown among the well-to-do but it is much more frequent in a poorer stratum of society. Overcrowding, insanitation, dampness and deficiency of diet have all been cited as contributory factors. |
2dc4a4d0-2e83-4edb-9e41-3f6da2d39efc | It will be interesting to see whether the large number of houses that are being built for slum clearance areas will result in a diminution of acute rheumatism in children owing to increased space and air or in an increase if these houses have been too rapidly and flimsily constructed to be weather-resisting in a climate such as ours. Acute rheumatism in Acton is at present, steadily on the increase and has been so since 1931. In 1936 there were twice as many cases as in 1935 and 1935 contained as many cases as the years 1931-1934 inclusive. It is hard to explain this. Acute rheumatism, according to expert observers of the disease such as F. J. Povnton, will come in waves some years and it may be that we are now approaching the crest of one of these waves. It is also a well known fact that once the need for certain facilities is recognised, the cases to be treated wall follow. |
6dbda2d4-3238-49c2-b668-6e1a21e80626 | Acton has a Rheumatic Clinic for its school children at the Princess Louise Hospital for Children. Here all suspected and diagnosed cases of rheumatism are referred and treated and when it is advised, arrangements are made for admission to an appropriate convalescent home. Acton children are not infrequently admitted to the West Wickham and the Edgar Lee Heart Homes and the Heart Home, Lancing. It is possible that these facilities are becoming more widely recognised and made use of and that this, in part, may account for the increase in rheumatic cases noted among school children. 100 Attention has been focussed so very much in recent years on the damage caused by untreated or inadequately treated Rheumatism in childhood that the careful observer is alert not to miss the early signs that will mean that early treatment which can promise an almost sound heart afterwards. It may be that the ever present thought of Rheumatism means earlier and readier diagnosis and treatment. |
cdb16fcd-ede8-4c8b-911e-02618c4a8e09 | It is by no means unusual however, even now, to encounter on routine examination, a child with a damaged heart and only a vague history of ill-health or "growing pains" sometime in the past. The child has not been ill enough at the time for a doctor to be consulted, but permanent damage has been done, resulting in the necessity for the child to be "followed up" for the rest of the school career in case of a recurrent attack. There is no evidence that Rheumatism in childhood is on the decrease either in numbers or in virulence. As this disease attacks those strata of society where physical fitness is most essential for wage earning, it will be seen how urgent a problem the proper care of rheumatism is and that its prevention is one of the most pressing of public health problems. » TONSILS AND ADENOIDS. 47 cases were operated on during the period January to December, 1936, for removal of Tonsils and Adenoids under the Authority's scheme. |
7da1293f-4b82-4261-ab5d-2487067ec5a3 | 39 were operated on for unhealthy tonsils and adenoids which have been giving rise to tonsilitis, frequent sore throats or colds, enlarged glands in the neck, &c. 2 had tonsils and adenoids, and 2 had adenoids only, removed because of continued ear discharge. 3 cases were operated on because of deafness, 2 having their tonsils and adenoids removed and 1 adenoids only. 1 child was operated on because she had Rheumatism and it was considered that her unhealthy tonsillar and adenoid tissue might be the focus of infection. AURAL REPORT. This year 102 cases were referred for examination and treatment to the Aural Clinic. This means an average of between 2 and 3 new cases every' week, so that it appears that full advantage is being taken of the clinic. |
849e6dac-91ee-4c73-8e42-852968865167 | Not all cases so referred are found to be Suffering from ear disease although most are, 101 Of the 102 cases referred in 1936 8 were found to-be suffering from wax in the ears only with no disease present. 4 were referred for deafness—3 of these were referred to the Ear Specialist at the Acton Hospital and removal of the adenoids or tonsils and adenoids helped the condition, another was only slightly deaf following a bad head cold and improved on local treatment. 15 cases were referred for earache, where the condition subsided on appropriate treatment and did not proceed to ear discharge. 71 cases of otorrhoea or ear discharge were dealt with during the year, and by the end of the year 61 of these had been discharged as cured, a percentage of 85.9. |
0a0e1c3c-164c-4c61-8631-c0a5d6d1db7c | Of the remaining 10 cases, 5 were no longer attending the Clinic but were receiving treatment at various hospitals, either having been sent there by us, or having gone there of their own accord, and 3 cases were in hospital and had been for an extended period for different diseases, i.e., eczema, lung trouble, &c. Of the remaining 2 cases, one was absent from school at the end of the year so the condition of the ear was not known, and one case was nearly well. 4 cases left school during the year, still suffering from otorrhoea. 2 of these were nearly well and were given advice as to how to proceed, 2 were hopeless cases, no amount of cajoling, scolding or threatening would make home treatment even reasonably effective. Advice was given, repeatedly given, to be ignored, and it is felt that these two children will inevitably suffer from impaired hearing. - The Ear Clinic has been run on slightly different lines this past year. |
390e3f1b-f9b3-4502-9c16-44b6760c9f7d | The ideal aimed at was the closer co-operation between doctor and nurse in the supervision and treatment of these ear cases. All cases therefore, were seen by the nurse three times a week and by the doctor twice weekly. This ensured that at least once a day on each school day the auditory meatus was made completely clean, and how important that is can only be appreciated by one who has had some experience of dealing with cases of otorrhoea. We are convinced that the results have justified the work entailed. Where it was thought that more frequent attention was necessary 102 the parent of the child was seen and instructed how to proceed, if the child were not old enough to be taught how to keep the ear clean by him or herself. As mentioned in previous reports, one of the most difficult things to impress on parents is the importance of Nose Hygiene in dealing with ear discharge. |
f6a38cd0-d998-414e-9d1d-c4edd584261a | Consent would willingly, in most cases eagerly, be given to operative measures such as removal of tonsils, but lesser measures calculated to produce a healthy nose ana naso-pharynx are only too often met with indifference and scepticism. A little lecture on Anatomy sometimes has the desired effect in stimulating co-operation from the parent. Where home treatment is not being carried out adequately, the parent is interviewed and instructed. Straight speaking is not always appreciated, as witness one case which had been resisting treatment through home neglect, and had in the end to be referred to the Acton Hospital where it was considered that a mastoid operation would now be necessary to cure the condition This the mother would not consent to, and said that she had never meant to allow any " interference with her son, although she had allowed us to send her to hospital with a letter and wasted the time of the specialist in seeing her boy. |
1cc9f9a6-0db2-452c-a5bf-a8850b8039fa | On being told that it was largely her own fault that there was any question of " interference," the mother left the clinic and took her child to another hospital, where similar treatment was advised and carried out. It is not often that such situations arise, in only 3 cases last year did the Clinic fail to obtain the willing co-operation of the mother, in others it may have meant repeated interviews but success was attained in the end. In comparing the figures for the clinic for 1936 with those of the previous year, it must be noticed how the cases of otorrhoea have increased. This may be explained, partly, by the fact that Measles was rampant in the first half of 1936 and the epidemic resulted in many cases of ear infectious. Last year this was found to be generally much more the case than is normal in Measles epidemics. |
714e022d-a33d-48c7-bee6-7e2e7498c3ee | In several cases where treatment was being carried out conscientiously, and the desired results were not being obtained, attention was directed to the child's general condition and success was attained when treatment was combined with general tonics and cod liver oil and malt. 103 Sometimes quite startling results are obtained by regular supervision and treatment, one case where ear discharge had been present for one year before attending school. After one months' treatment at the Ear Clinic, the ear ceased to discharge and has not recommenced, having been dry now for some months. Such results are encouraging and stimulate us to continue the attention and care which the Ear Clinic endeavours to supply. PROVISION OF MEALS. As formerh, meals continue to be granted to necessitous school children who are suffering from the effects of malnutrition. It not infrequently happens that children are sent along to be examined with a view to recommendation for free meals, because their fathers have fallen out of work. |
aa8a5d6f-721d-404d-bb83-925801d936f8 | On examination these children may be, and often are, found to be in good condition, well up to the average in development, and in bodily and mental vigour. It seems therefore sometimes that the careful and conscientious parent is penalised at the expense of the careless and thriftless. These children cannot medically be recommended for free meals and milk, but they are kept under observation, and should the new financial conditions in the home be leading to loss of weight, pallor, listlessness or flabbiness, then a recommendation can be made so that the former good condition can be regained or maintained. Very rarely is it necessary to place these children on the feeding list, as the careful mother seems to manage, even when the father is out of work, to keep the children in good condition. How far these conditions would obtain if unemployment continued for more than a short period, is a debatable point; experience in the distressed areas points to the inevitable conclusion, that prolonged unemployment leads ultimately to deterioration in the general condition of the children. |
dc7a1832-b396-43f6-9b44-aa1a925367b2 | While no great expenditure is called upon in the way of clothes or boots or medicines, &c., it is possible to imagine that a careful mother would manage to maintain conditions in the home as formerly, but any excess expenditure must mean shortage somewhere else, and it is then that the strain would be felt. One case can be instanced to show the good sometimes done by free meals and milk. C.G. when first seen at 4½ years was whitefaced, listless, flabby and underweight. Free meals were recommended, and in three weeks she had put on nearly 3 pounds, was much brighter and was beginning to have some colour in her face. The improvement in her general condition was most noticeable and very gratifying. 104 The numbers of children on the free meals list during the year are as follows:— Meals and Milk. Milk only. No. |
2616896f-be30-406d-a0eb-151ef52fb404 | in quarter ending 31st March 250 70 30th June 230 80 30th September 200 80 31st December 220 80 The actual numbers of free meals and bottles of milk supplied are:— Meals. Milk. Quarter ending 31st March 12019 30399 30th June 9223 24195 30th September 6948 20054 31st December 9837 26718 Total 38027 101366 During the year it was considered that if so many children were medically in need of meals, it must be detrimental to them if they were deprived of free meals during the holidays. It had not been the practice to supply meals during the holidays up to then. During the Christmas holidays therefore, three Centres were chosen, and meals were supplied to the children there on every day except Saturdays, Sundays, Christmas and Boxing Day. |
8a94f9f8-97b5-4c1e-8b93-9fc29e702baa | The attendance was very good, out of a possible 211 children, 188 attended, and out of a possible total of 1880 meals, 1539 were served. The facilities were evidently appreciated, and the opening of the Centres for the purpose of holiday meals was justified by the good attendance of the children. Approximately 150 families were helped with free meals or milk during 1936, the numbers in the families ranging from one to six. Speech Training Classes. Classes for speech training are still being held at the Priory School twice a week. The Stammerers are now divided into two classes, one for children of ten years and under, the other for children of eleven 105 years and over. In these classes, which last for three quarters of in hour, most of the time is used for muscular relaxation. The children are prepared for this by simple exercises and suggestion of a feeling of ease, they then lie down on their mats and cushions for a short period. |
58f313d5-00da-4bf3-9dd1-7b095645b4fd | The rest of the lesson is taken up with conversation about the relaxing and about the everyday interests of the children, rhythm exercises, recitation and easy talking games. The Speech Defect cases are divided into small classes according to the type and degree of defect. There is one case of cleft palate speech, and one or two cases of lisp, the other children are all cases of delayed speech or bad articulation owing to faulty speech education in the very early stages. Two children suffer from slight deafness which has retarded their speech. The normal child should be able to say a number of words before he is two, and should be able to talk freely by the time he is three years old. Inability to do this is due either to neglect or to the fact that the mother encourages the child's baby talk and does not attempt to teach him to say his words properly. Mothers frequently report that they can hear what their children say ; it does not seem to occur to them that it matters whether anyone else can understand them. |
1fbbe8c2-46dc-4adb-bd4f-b46c80b64535 | It is necessary in most of these cases to re-educate the speech and teach the children to copy every shape and sound by the mouth. The children practice breatheing and mouth flexibility exercises, vowel and consonant sounds, repetition of simple nursery rhymes and jingles, and singing games. It is extremely tiring to work the mouth in a way to which it is not used, and an important point in these lessons is to keep the children interested in a variety of ways during a short lesson so that they do not realise the physical exertion and become fatigued. For this reason a certain amount of apparatus is employed in the form of large cut-out letters which the children can feel with their fingers and speak the sounds and gradually build up into words. Picture books are very popular and the smaller children enjoy describing the pictures and re-telling stories about them. The older children like drawing and writing and are very often unconsciouosly learning the correct production of a sound they are writing by mere repetition. |
6297c352-1f6c-415e-ba60-a0409ec0173a | The children are encouraged to bring drawings or toys they have made at home, and this term we have been growing some bulbs in order to keep them interested in coming to the classes and to help them to learn to have confidence in themselves through their mutual interest and occupations. As a rule the cases of delayed or baby speech and bad articulation do not take long to cure. This depends on the general intelligence of the child. The children who are deaf or are less developed mentally take a long time to realise the difference between 106 their speech and other peoples' and are therefore slow to improve. The more intelligent child, however, who readily grasps what is required of him may show a big improvement in a few weeks. The figures for 1936 are as follows—At the beginning o January 1935, 12 stammerers were attending the classes and during the year 7 more were admitted. |
92463aad-0b8f-4532-8f5f-62e62cba3ce9 | Seven of these children were bad stammerers, 2 are not improved but the others are much better although none are yet cured. One has since left school, much improved. 4 were cases of stammering of moderate severity, 1 has been cured, 1 so much improved that he is only under supervision in case of relapse, and 2 are much improved—one of these has since left school. 8 were mild stammerers. 6 of these were much improved and the other 2 were transferred to the Speech Defect Class as being more suitable to their condition, and one of these has since left the' district. One mild stammerer has also left school but was much improved. By far the greater number of children attending the Speech Training Classes in 1936 were cases of delayed or baby speech. There were 37 children attending at January 1936, 34 of these were cases of baby speech. |
bd553d19-1490-4ed8-99e6-9fe1726b12a3 | 10 were mild cases, and of these 6 were cured, 3 much improved, and 1 went to a Convalescent Home for some other complaint. 11 were cases of moderate severity, 6 of them were cured, 3 improved, and 2 did not improve. 13 cases were suffering from bad speech defect, 10 of these were improved, 1 left school, 1 left the district, and 1 refused to attend the classes. Of the 3 remaining cases, 1 case of true lisp left the district before much had been accomplished, 1 who spoke badly because he was deaf ceased to attend the classes as it was not making any difference to his speech, and 1 who spoke badly because of cleft palate improved very much. During the year, 10 more cases were admitted for speech training, 3 of these were suffering from lisp, 1 bad and 2 mild cases. |
b174dfce-9257-46d9-b9c0-bfb24a5eb6dd | The bad lisp left the class to go to a Convalescent Home, and of the 2 mild cases one improved and one left the district. 1 child was sent to the Speech Classes because slight deafness made him speak badly, his parents removed him from the class because they did not think it was doing him good. The 6 others were cases of 107 delayed or baby speech. 3 were bad cases and 3 mild. One bad case showed little, if any, improvement, 2 others improved verymuch. 2 of the mild cases improved and 1 was sent to a private school before results could be obtained. EXCEPTIONAL CHILDREN. On Table 3 will be found a return of the exceptional children in the district. Partially Sighted Children. One child, although her sight is very much impaired, attends an ordinary elementary school. |
debf62a6-e4cc-4847-b413-bcecc0930b8c | She attends hospital regularly and in answer to a recent enquiry from us, the hospital authorities stated that they considered it perfectly satisfactory that she should do so, and that it was not detrimental to her future. The other 3 children attend Kingwood Road School. Deaf Children. 5 children are attending Ackmar Road School for the Deaf, 2 girls and 3 boys: Two of the boys are brothers and are deaf and dumb. Mentally Defective Children. 43 children are at present attending the Acton Special School for Mental Defectives, 16 girls and 27 boys. During the year there have been 8 new admissions. Epileptic Children. 3 children in the Borough suffer from severe epilepsy. 1 is resident in Lingfield, and 2 are at home. Tuberculosis Children. 2 children are in institutions suffering from tuberculosis of the lungs, one in Harefield and one at Tadworth. |
633d12ee-c60f-4850-acd8-48706c1ad801 | 3 children suffer from non-pulmonary tuberculosis, one is in the Victoria Home, Margate, and 2 are now at home and attend hospitals in London. Crippled Children. 10 children are contained in this category, 6 boys and 4 girls. One of the boys is at the Shaftesbury Home, Hastings, 1 attends Brook Green School. 3 are attending ordinary elementary schools 108 but are under hospital supervision, and 1 is an in-patient of Middlesex Hospital. 1 of the girls is in St. Vincent's Home, Pinner, 1 attends Queensmill Road School, 1 attends Faroe Road School, and the other is an out-patient of Middlesex Hospital and attends an elementary school. Delicate Children. This year 14 children come under this heading. 9 are suffering from the effects of rheumatism, 1 is in the Heart Home, Lancing, 1 at St. |
e3e63db8-f444-474b-ad82-ebc55c737479 | John's Kemp Town, Brighton, 1 is an in-patient at the Princess Louise Hospital, Kensington, 1 attending that hospital as an out-patient, 1 attending school for half days only meantime. 1 attending an ordinary elementary school while waiting for a vacancy at an open air school, and 1 has just recommenccd school after three months at a convalescent home at Bexhill. 2 other children are at home and attending hospitals as out-patients. Of the other 5 children, 2 are suffering from malnutrition, (1 is at the Royal Sea Bathing Hospital, Margate, and 1 is waiting for admission to an open air school). 1 child, suffering from fibrosis of the lungs, is waiting for admission to an open air school, 1 who had suffered from Tubercular Adenitis is attending an open air school, and 1 girl who had been for a a long time an in patient at St. |
800b1907-cb6e-4162-b2f7-88c3f6966713 | Vincent's Hospital, Pinner, is attending Wood Lane Open Air School. REPORT OF THE SCHOOL OCULIST. In the past twelve mouths 397 children were referred to the Ophthalmic clinic for examination. Of these 41 refused treatment or left the district, 10 obtained glasses privately, 84 were found not to require glasses, and glasses were prescribed in 262 cases. 16 cases of external disease of the eye attended for treatment. 41 boys from the Junior Technical and County Schools were examined. 30 of these were provided with glasses through the clinic, and 4 refused treatment or obtained glasses privately. 7 were found not to require treatment. 17 children from the Welfare Centres were examined, and of this number 10 were supplied with glasses through the Clinic 1 was treated privately, and 6 were kept under regular observation' 4 children were referred for treatment of external diseases. 109 During the year there has been a marked improvement in the co-operation obtained from parents of children suffering from squint. |
db90577e-53d7-4e52-a925-44b2d746a9a8 | The Clinic has been supplied with extra apparatus for the investigation of cases of squint and muscle balance, and all children attending have their muscle balance checked both before and after refraction. Children suffering from defects of this kind, attend on the average once a month. This record of their progress makes it possible to discover those cases in which the "home treatment" is not being adequately carried out and serves to maintain the parents' interest in the progress made by their children. In the period covered by this report, no case of ocular disease due to undernourishment or bad living conditions was observed.' A few cases of congenital defect and diseases either transmissable or hereditary are under treatment or observation. SCHOOL DENTAL REPORT. The work of the Dental Department in 1936 had to be reorganised and extra assistance called for to as great an extent as the present premises and accommodation would allow. |
967278ba-e95f-40df-b958-c5a2be1fbebe | It was found with the increased work resulting from the exanunation and treatment of the Junior Technical and County Schoo's and the growing use of the department by the Child Welfare Clinics, that the unavoidable delay which arose before treatment could be undertaken, was in danger of rendering the service inefficient. If such a period has to be spent on the waiting list that when the patient comes up for treatment it is too late for conservative measures, and extraction has to be resorted to, the aims of the service are being defeated and the patients are not receiving the attention they should Conservative work naturally takes much more time, but a realisation of its importance has caused the request for assistance in this branch of the work for three half-days per week. As stated before, the present accommodation does not allow of more help but it is felt that considerably more assistance will be necessary is future to render the service 100% efficient. |
58d0e792-ad11-4ec7-84a4-576e3820297c | Use continues to be made of the department by expectant and nursing mothers, and this year the number of dentures fitted for mothers from the Child Welfare Centres has risen from 19 to 34, each of these representing several ordinary appointments. The number of extractions in 1936 is rather less than in 1935, but this is explained by the fact that a tremendous drive took place at the end of 1935 to clear off a long waiting list, the extra 110 sessions thus arranged artificially sending up the number of extractions for the year. |
1c3ebe85-fb9b-4c14-a8f8-da5244c47ac3 | It has been necessary also in 1936 to have extra extractions sessions whenever it was found possible to fit them in, as otherwise the waiting list tended to become unmanageable Ideally the position would be such that at the end of the year only so much work remained as could be overtaken while the new year's work was being organised, but that at present is unfortunately not the case, as over 1000 cases at the end of the year were waiting either treatment or consent for treatment, this representing a lag of about 2 months. The time lag is greater than this seems, as unfortunately it is not always possible for appointments given, to be kept by the patients. This means waste of valuable time which might have been filled by someone else on the waiting list, as notice may not be given in time to make a further appointment. |
01e5bfc4-affb-4ea4-9e45-14612837eb58 | Where a reason for not keeping the appointment can be given, further appointments can be made, but "did not turn up" is an all too frequent cause of wasted time which might have been spent in reducing further the waiting list. Figures for the work carried out for elementary school children are contained in Tables at the end of the report, and below are figures for work carried out on the Technical and County Schools, and for the Welfare Clinics. Secondary Schools. Welfare Centres. Mothers. Children. Inspected 638 88 155 Referred for trt. 453 88 135 Treated 241 90 135 Attendances 493 Fillings 385 411 Extractions 165 66 Dentures 34 934 Other operations 66 108 INFECTIOUS DISEASES. Diphtheria. During 1936, only 12 cases of Diphtheria were notified in the Borough, making this a record year. |
b6094e51-336b-4e25-a833-d386751865d3 | There were 2 deaths, for both of whom immunisation had been refused. 111 1936 was a poor year from the immunisation point of viewin the Borough. Every effort was made to keep up the herd immunity, but owing to the relative freedom of the district from Diphtheria, the interest of the parents in artificial immunisation was difficult to rouse. Children also who had been inoculated against Diphtheria three years ago were offered re-inoculation to keep up their level of blood immunity. To begin with, and as reported in the Annual Report of 1935, all children who had been immunised three years ago were Schick tested, and only those found to have relapsed into positive Schick reactors were re-immunised. At present the Schick test is the only indicator at our disposal for widespread use in a community test to the level of blood immunity reached. |
d81bf901-f9a9-47ce-b373-70d720b1e84e | That Diphtheria can and does occur in subjects who have been rendered Schick negative, seems to us an indication that to a large extent our efforts in this line were waste of time. Here and there, all over the country, from time to time clinical Diphtheria is found in those who are or who have been rendered Schick negative, and although the fact that the great majority of these cases are mild or moderate attacks of the disease is matter for congratulation, it is unsatisfactory that "Schick negative" is not synonymous with "immune." In an article published in the Lancet in March 1935, H.J. Parish and J. Wright gave data of investigations made by them into the "Schick level" They found that in Schick negative reactors there might be a titre of immunity only 1/16th of What is supposed to result when inoculation has produced a negative Schick reaction. |
2fe91b53-9d0a-420f-9c52-529d7ad4de31 | In the same article the writers gave figures from some preliminary experiments with "multiple Schick toxins" where the combining power was 4 to 10 times as strong as the material commonly used. With "fourfold" Schick toxin, negative Schick reactions were obtained where the titre was only l/3rd that which was supposed to result from inoculation which rendered the subject Schick negative. It must be seen then, that the Schick test as commonly used is not a sufficient index of the level of immunity. During part of 1935 and 1936 tests were made of comparison between the numbers of Schick positive reactors obtained when ordinary Schick toxin and fourfold Schick toxin were used on the same person. A total of over 500 cases are recorded and the results are tabulated below. |
2499113b-9be6-4f55-b6e1-63cb6118db0d | The precedure was as follows:—a control—fourfold—was injected into the right arm, and ordinary Schick toxin was injected 112 high up into the left forearm and fourfold toxin lower down is the left forearm. Results were read on the third day. Years of Age. Total 1 2 3 3 5 6 7 8 9 10 11 12 13 14 No. tested 6 12 3 14 29 35 38 62 62 49 68 59 66 8 511 Neg. both toxins 6 12 3 13 27 28 27 49 51 38 60 42 50 6 402 Pseudo - - - - - 1 2 1 1 2 2 2 6 1 18 Pos. |
31c35ede-eca3-4246-9bea-b800c0db882e | both toxins - - - - - 1 3 1 3 1 4 7 4 - 24 Pos. only with 4-fold, negative ordinary toxir - - - 1 2 5 6 11 7 8 12 8 6 1 67 It will be seen that of the 511 eases tested, 24 were Schick positive by the ordinary testing, but 91 were positive when fourfold toxin was used. In other words, by ordinary methods only rather under 5% of cases gave positive reactions, while with fourfold toxin 17.8% gave positive reactions. The total number of Schick positives is smaller in both cases than would be expected in an open community, as included in this total were many children who were being tested 3 years after primary inoculation. It was not felt that the position was satisfactory. |
2615c7db-9343-4021-9ba4-1d26515d666d | There are no figures available—indeed the time during which the stronger toxins have been used has not been long enough to show of the strength of toxin necessary to ensure that a negative reaction is synonymous with complete protection. With a fourfold testing toxin, three times as many children appeared to be susceptible to Diphtheria, with a tenfold toxin the number might again be trebled, but even then we have no proof that those children rendered negative to such a toxin would possess a 100% immunity. With a test at our disposal, which is not of reliable index of immunity against Diphtheria, what, it was thought, of the false sense of security which might dull a highly "immunised" community to the possibility of their children meeting and falling victims to a virulent outbreak from outside? From an administrative point of view the position looked alarming. |
def8141d-cc1e-461a-b22a-a46c425a107b | It is possible, and has to a large extent been done in Acton, to crush Diphtheria almost out of the young population so that no longer in their ordinary lives do the children meet the small sub-clinical doses of infection which 113 might help to stimulate their perhaps waning immunity. It is conceivable that the last state of that community might be worse than the first. Immunity conferred for a long enough period to make Diphtheria a rare disease, and then allowed to lapse, leaves a community lulled by a false sense of security, a community which would be virgin soil for a virulent infection from outside. In Acton therefore in 1936, a new technique has been adopted which it is hoped will lessen the risks of such an invasion. Babies, pre-school children and school children are still inoculated as before, and Schick tested afterwards to ensure that that level of immunity is at least reached. |
aab06195-d309-44bf-8b77-8e9d8bac174d | We do not know that it is a safe level but it is at least better than no level at all. Fourfold toxin is now used entirely for Schick testing, no weaker toxin is used in the Borough, so that the "Schick level" is as high as practicable. The immunity thus conferred is kept up by regular injections of immunising material every three years so that until the child leaves school protection is maintained at that level as far as possible. Time only will show whether the level attained and kept is sufficient to prevent Diphtheria altogether in inoculated children, but it is felt that the community is by this method much more efficiently protected. Eight cases of Diphtheria occurred in school children and there was one death, in a boy whose parents had not had him protected. The schools at which these cases occurred were 1— Acton Wells; 3—Berrymede; 3—Derwentwater and 1—Priory. |
bd180a20-54d7-4ee3-bcc3-3216dda5482d | It is significant that with these four exceptions the schools were completely free of Diphtheria. This has its dangers, which we are already facing, because this freedom from infection has bred a feeling of apathy and indifference in the parents. The immunisation figures for this year are low as compared with last year, although the same facilities have been offered and the same course of action urged as formerly. The herd immunity in most of the spools was much lower at the end of 1936, as compared with the end of 1935. It appears as if the seeds of failure were contained in our successful efforts. The fear of Diphtheria drove the people to artificial immunisation, and we were in sight of complete freedom from the disease. In the last 7 mouths of 1936 only 2 cases were notified, with no deaths. The immediate effects of our efforts to stamp out Diphtheria have obviously been successful, but we are apprehensive of the future unless these efforts continue to be successful. |
0132f030-dd14-4423-9d23-5d26803ade32 | 114 The comparative freedom of the district from Diphtheria has deprived us of the material by which the population became naturally immunised by sub-clinical doses, and unless we can replace this deficiency by artificial immunisation, we may again be in danger of an epidemic of the virulent type. 11 Diphtheria patients and 39 contacts were seen at the Office before returning to school. Diphtheria Immunisation—1936. Schick Tests. Positive reactors. 1st. dose. 2nd. dose. 3rd. dose. A.P.T Acton Wells Junr. 2 2 2 2 2 - Acton Wells Infants - - 13 15 14 1 Beaumont Pk. Infants - - 2 2 4 - Berrymede Jnr. Boys 48 23 23 16 13 - Berrymede Jnr. |
0b2d043f-2603-4410-855d-1250a93a57bf | Girls 43 21 22 14 8 - Berrymede Infants - - 16 17 13 2 Central — - - 2 2 - Derwent water Junior 2 1 2 2 2 - Derwentwater Infants - - 35 26 22 7 John Perryn Senior - - 1 1 - - John Perryn Junior - - 1 - 1 - John Perryn Infants - - 20 20 19 3 Priory Boys 2 1 1 5 2 - Priory Girls 1 1 1 5 3 - Priory Infants - - 15 2 4 3 Rothschild Junior - - - - - - Rothschild Infants - - 16 11 10 1 Southfield Snr. |
d4a6196d-aef2-42d7-b1dd-f3da6d69a1dd | Boy3 1 - - - - - Southfield Junior 1 - 2 8 9 - Southfield Infants - - 16 21 14 - Roman Catholic 1 - - 1 6 - Other Schools 2 1 2 1 1 - Infant Welfare - - 62 58 67 103 103 50 252 229 216 120 246 children were Schick tested after 6 months, 21 of whom were found to be positive and were given one more dose. 262 were Schick tested after 3 years, 54 were found to be positive and were given another dose. 382 were given one more dose after 3 years (without Schick testing). 115 As will be seen, there is an extra column in the inoculation table. This is inserted because this substance, A.P.T., is used in 2 doses only. It is given to younger children. Scarlet Fever. |
251cb21d-e6ef-413e-aa1f-c635c467199a | During 1936 there were 98 cases of Scarlet Fever in School children. This is an advance on 1935 when there were only 48 cases. The schools affected were:— Acton Wells 60 Priory 7 Beaumont Park 6 Rothschild 3 Berrymede 1 Southfield 5 Derwentwater 13 Roman Catholic 2 John Perryn 1 98 It will be seen that the bulk of the cases occurred at Acton Wells School. The cases occurred during the year as follows:— March 1st, April 2nd, May 4th, June 2nd, July 4th, August 3rd, September 3rd, October 15th, November 18th, December 6th. More than half the cases came in the Autumn when the incidence of Scarlet Fever normally rises. 90 Scarlet Fever patients and 195 contacts were examined at the Office before their return to school. Measles. |
0b4bf83e-cf67-4707-b1b3-c26e2c54a5d0 | 1936 was a Measles epidemic year and as is usual in such circumstances all the schools of the district suffered. In the report of the Medical Officer of Health, it is explained how Measles for many years has made its appearance in Acton regularly every other year. The epidemic usually occurs in the form of an explosion, 2 large number of the susceptible children suffer from Measles in the course of few months, and the district is then entirely free of the Hsease until the appearance of the next epidemic. In this respect it differs from Scarlet Fever. Even in non-epidemic vears odd cases of Scarlet Fever are reported and in our large towns, Scarlet Fever is said to be endemic. The previous epidemic of Measles occurred early in 1934, and the district was free of the disease in the fourth quarter of 1934 and the early part of 1935. |
fbb01216-d2b4-491f-a1dd-8bd7b3f2cb05 | The first case from a school here was reported on November 26th 1935, and the child attended Derwentwater Infants' School. On enquiry at the home, it was found that a younger child of pre-school age had had Measles two or three weeks previously. As far as could be ascertained these were the first cases in the district. 116 Between December 5th and 10th, 9 other cases occurred amongst children attending the same class as the November case 2 cases occurred in another class, and 1 each in two other classes in the same department. These 13 cases were the first crop. Most of the second crop fell during the Christmas holidays. 3 cases occurred among children attending the Infants' department of the Priory School. The date of onset was given as December 18th. |
68dbe29a-dd59-4e41-8a6f-44cd3a2916c3 | When the schools were re-opened after the Christmas holidays, 43 cases were reported from different classes in 3 Infant departments, and in the following months all the schools were affected. The epidemic was extensive, but compared with former years, the fatality was light. In the first decade of this century. Measles was one of the most formidable problems which we had to face, and no other disease caused so much dislocation of school administration. It caused more deaths than all the notifiable diseases put together. In the four years 1906 to 1909, we had 125 deaths from Measles alone. It can thus easily be understood how everything was tried to postpone or to control the course of an epidemic. Among the measures adopted were the closure of schools and departments for indefinite periods, and the exclusion of all children from an infected family and house from school at tendance. |
ff0a3171-dd7f-475e-8993-c662f46221d0 | It can be imagined to what extent a Measles epidemic in those days interfered with the educational machinery, and the irritating part of the proceedings was that the measures adopted were almost useless. A more intimate study of the epidemioloey of Measles showed us the reason for the futility of the methods in vogue, and gradually a change of procedure took place. At the present time, school closure is hardly ever resorted to. The disease is infectious from the appearance of the corvzal symptoms, and this dates some daysbeforethe appearance of the rash. It is possible in hospital to diagnose the disease before the appearance of the rash and possibly before the disease is infectious. Koplik's spots make their appearance on the inside of the cheek and mouth early in the illness before the appearance of the rash, and when these are sought in contacts an earlier diagnosis can be made and the sufferers isolated. Such a diagnosis is not feasible in children attending school in them the diagnosis is not made until the rash appears. |
dd44dbb0-946b-4283-ad0f-c6f837b3424e | Usually the child attends school during the early stages before the appear ance of the rash, and the mischief has been done, as the children had attended school during the most infectious period and a numbers of contacts would be incubating the disease when the school or department was closed. When the schools were closed the contacts who would develop Measles among the excluded scholars, would 117 not only be liable to infect the children from their own homes (which they would do in any case) but would probably infect children from other schools. Their own schools being closed, they would Seek recreation in the playgrounds of other schools. Besides, unless the Sunday Schools were also closed, we could not cxpect success. At the present time, if quarantine is to succeed, we should have to include cinemas among the banned spheres, For these reasons school closure has been abandoned. There are other reasons against school closure, and for the modification of individual exclusion from schools. |
c9d87222-1f73-4469-a9cb-1c46eaa91695 | It has been Shown that a Measles epidemic does not arise in a community until the percentage of susceptible children rises beyond 25% and seldom Subsides until this susceptible population is reduced to under 20%. During an epidemic not only is there a permanent immunity which an attack of Measles confers, but a certain amount of temporary latent immunity also occurs. This occurs with every epidemic So that when a child who attends a public elementary school reaches the Junior department stage, he or she has either suffered from an attack of Measles, which usually confers a permanent immunity, or has acquired immunity through successive sub-clinical doses ; he or she is not likely to suffer from another attack of Measles. • For all practical purposes, under present conditions. Junior and Senior departments of elementary schools are not factors in the spread of Measles, and can be ignored. We do not therefore exclude contacts from these departments and there is no spread of the disease among the pupils of these departments. ' |
7d29f747-1c79-4f97-beaf-2200cf6f1c47 | Even in Infants departments those who have already had an attack of Meases are not excluded because they are contacts. The revised Code Regulations have facilitated these procedures. Formerly for grant purposes, it paid to close, a department or school because the average attendance might drop very low, but now if the attendance drops below a certain mark on account of epidemic disease, a Certificate to this effect enables the weeks of low average attendance to be ignored in the calculation of the grant. Scabies. Scabies is a highly contagious skin disease caused by the burrowing of a minute animal, the Acarus Scabiei, under the skin of hands, feet, and body. The resulting skin affection is very itchy, the itching being worst at night. The usual treatment consists of sulphur baths to the infected person with the use of sulphur 118 ointment, baking of the infected clothing and disinfection of bedding and premises. |
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