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359b4bf7-74fa-4a51-9ade-757dabc9c677 | Total Births notified in the district 416 136 74 66 140 Notifications received from other districts 493 175 121 88 109 Notified Still Births. Inside 14 Outside 22 Total 36 Notifications were received from:— Doctors and Parents 666 Midwives 243 61 TABLE 8. INFANT WELFARE CENTRES, 1938. |
06c6b598-09e4-4d04-ab6b-533ae93dfe8e | 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 11,757 (b) by children between 1 and 5 years of age 6,809 Average attendance of children per session 43 Number of children who attended for the first time during the year:— (a) under 1 year of age 720 (b) between 1 and 5 years of age 191 Percentage of notified live births represented by number of children who attended a centre for the first time during the year 83% Children treated at Dental Clinic 78 Children treated at Ophthalmic Clinic 22 Mothers treated at Ophthalmic Clinic 1 Children operated on for enlarged tonsils and adenoids — Children operated on with X-Ray for Ringworm — TABLE 9. ANTE-NATAL CLINIC. |
beb15d64-08dd-4518-a146-3295076ffc36 | Number of Expectant Mothers who attended 501 Number of attendances made by Expectant Mothers 1,051 Mothers referred for Dental treatment at the Clinic 174 Mohers supplied with Dentures 28 Expectant Mothers to whom Dried Milk was supplied free 21 Number of packets of Dried Milk supplied free 1,133 62 INQUESTS. Suicide 5 Accidental Fall 3 Run over by Motor Lorry 3 Run over by Motor Bus 2 Motor Car Accident 2 Jumping off a moving Bus 1 Knocked down by a Steam Train 1 Collision between Cycle and Motor Car 1 Found Drowned 2 Accidentally Drowned 1 Striking Head against Door 1 Inhalation of Vomit 1 Pneumonia 1 Accidental Burns 1 Total 25 POST-MORTEM WITHOUT INQUEST. |
e1958bf0-febd-4ff0-864c-7092ba236dcb | Heart Disease 13 Pneumonia 4 Cerebral Haemorrhage 3 Meningitis 2 Cancer 1 Pyleonephritis 1 Gastric Ulcer 1 Arterio-sclerosis 1 Diabetes 1 Pernicious Anaemia 1 Perforated Caecum 1 Asthma 1 Bronchitis 1 Peritonitis 1 Total 32 63 FACTORIES ACT, 1937. 1.-Inspection of Factories, including Inspections made by Sanitary Inspectors. Premises. Inspections. Written Notices. (1) (2) (3) Factories with mechanical power 219 27 Factories without mechanical power 134 14 Other Premises under the Act 37 5 Total 390 46 2.—Defects found in Factories. Particulars. Found. Remedied. |
a946b2a4-6d4f-453d-9e95-dcef77643807 | (1) (2) (3) Want of Cleanliness (S.1) 8 8 Inadequate Ventilation (S.4) Nil Nil Overcrowding (S.2) Nil Nil Ineffective drainage of Floors (S.6) 2 2 Other Offences 2 2 Unreasonable Temperature (S.3) Nil Nil Sanitary Accommodation:— Insufficient 2 2 Unsuitable or defective 31 31 Not separate for sexes 4 4 Total 51 51 3—Outwork in unwholesome premises, Section III. Nil 64 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. |
a9c94a79-30ce-4ec5-984e-19a89868e241 | School Dentist 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, M.R.San.I., 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 and Smoke Certificates, Sanitary Inspector. A. H. G. Johnson, Cert. of Royal Sanitary Institute; holds Meat Certificate; Meat Inspector. Miss B. G. Sorlie, s.r.n., Certificate of Royal Sanitary Institute, c.m.b., H.V. Diploma, Health and School Nurse. |
8ccb0ce7-8118-4bdf-b6ae-40bb05e7f1c2 | Miss W. E. Bennett, s.r.n., Health Visitor's Certificate of Royal Sanitary Inst., c.m.b., Health Visitor School Nurse. Miss W. L. Orfeur, s.r.n., Health Visitor's Certificate of Royal Sanitary Institute, c.m.b., Health Visitor and School Nurse. 65 Miss A. Woosnam, s.r.n., c.m.b., Health Visitor and School Nurse. Miss N. Lapham, s.r.n., Certificate of Royal Sanitary Inst., c.m.b., Health Visitor and School Nurse. A. S. M. Pratt,* Barrister-at-Law, Chief Clerk. Miss A. Kent,* Clerk. Miss J. Warburton, b.a. (hons.), Clerk. Miss V. Slack,* a.c.t.s. Clerk. Miss J. Wood,* Clerk. Miss M. G. Hester, Clerk. Miss F. A. Cavendish, Matron, Day Nursery. |
f0309de3-342f-4cf7-b67c-972e1e77dc52 | C. Baker,* Disinfector. T W. Mason,* 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 am, Your obedient Servant, D. J. THOMAS, Medical Officer of Health. 66 ISOLATION HOSPITAL. On April 1st, 1938, the Isolation Hospital was taken over by the Acton and Wembley Joint Hospital Committee. The following is a copy of the Report submitted to that Committee. SCARLET FEVER. 454 case of Scarlet Fever were admitted, but 23 of these were diagnosed as not suffering from the disease. With the changing views concerning the nature of Scarlet Fever, it is frequenlty very difficult to decide whether the case can be accepted or not as Scarlet Fever. The vast majority of the cases admitted have a definite train of signs and symptoms. |
68fe2f01-1f00-4f76-8db7-03607a0aaffc | The earliest symptom is usually a sore throat, accompanied by a temperature which frequently reaches 103, 104 and 105 degrees. The throat is congested and the soft palate may be uniformly injected or it may have the appearance of a punctate rash, which may be regarded as the enan them of the disease. The tongue, at first furred, afterwards assumes the typical strawbeny appearance. When these signs are present there is no difficulty in the diagnosis, but the conditions may be modified to an extraordinary degree. Clinical Scarlet Fever is now regarded as a manifestation of an infection with a haemolytic streptococcus in a person who is susceptible to the effects of the poison produced by it. Some persons possess a partial or complete resistance to the poison, but the resistance may be insufficient to protect them against local or general tissue invasion by the streptococcus itself. |
dcb73477-a1b0-4010-a420-a58a4cf0d301 | More over streptococcal strains differ in their capacity to produce rashes; in some it is so high that most of those infected develop them: on others it is so low that only a small proportion of those infcetal exhibit the characteristic rash. It will thus be appreciated that frequently the difficulty of the diagnosis is fundamental, and not due to want of skill. The conditions are so variable as to warrant the assumption that the disease we call Scarlet Fever is not a Speciticentity but caused by different strains of the streptococcus. The conditions are too variable to be explained only by the resistance of the individual, but also that they are due to different degress of virulence in the different strains. Only one death occurred from the disease, and this Fact is sufficient to indicate that the type of disease was mild. A study of the history of Scarlet Fever shows that throughout some centance it has varied greatly in its severity. |
8868127a-25b8-40d3-af41-2126baaea8a0 | A mild type would be followed by one of extreme malignancy, and mild and severe epidemics have alternated throughout the ages. For some years now, thf cases admitted have been of a mild character, and last year there was no evidence to show that the disease is at the present time assuming a more severe character. 67 There were 14 return cases from 13 infecting cases. Return cases have been defined by the Society of Medical Officers of Health 26 "cases occurring in the same house or elsewhere and apparently traceable to the person released within a period of not less than 24 hours, or not more than 28 days, after his return from release from isolation." The patient released from isolation and the cause of the "return" case is called the "infecting" case. The period of one month is an arbitrary one, but useful, because it is presumed that a Scarlet Fever patient is not usually infectious for more than one month. |
d2abf65b-2bc9-4734-bb81-4ba84eb46bae | Although this is true of the vast majority of cases, there is evidence that Scarlet Fever patients may remain intermittently infectious for very long periods. We had many such cases last year and Lne following are given as instances. Mrs. L. was admitted on April 8th, 1938, suffering from Scarlet Fever. Her son had been in Hospital from October 18th, 1937, to February 2nd, 1938. His prolonged stay in the Hospital was due to Otorrhoea and subsequent Mastoidectomy. The boy was quite tree from symptoms 5 or 6 weeks after leaving Hospital, when he developed a "cold in the head," with a marked nasal discharge. Another case occurred in the same house after a period of more than 4 months since the release of the infecting case. M. J. was admitted suffering from Scarlet Fever on May 23rd, 1938. |
0b08ae86-2d2d-4aac-bc1d-9179bdd464a3 | His brother had been in Hospital from December 28th, 1937, to January 18th, 1938. The first case had been "clean" and without complications in Hospital. A third case occurred after 5 months. G. C. was admitted on October 14th, 1938. His sister had been in Hospital from April 10th to May 14th, 1938. The first one was a straightforward, uncomplicated case. These cases occur too frequently to be mere coincidence; they are more likely to be instances of prolonged intermittent infection. From an administrative point of view, these possible instances of possible prolonged infection are of less importance than those which are included as " return " cases. It is suggested that sence of the return cases can be avoided, and it may therefore be profitable to examine more closely the conditions under which they occurred. |
f7df6890-663a-4f5f-97c3-4efd00c044e4 | "Return" cases are not entirely a phenomenon of hospital isolation, as they occur also after the release of a patient from quarantine when the case has been nursed at home. The Medical officer of Health of Brighton published some figures of return cases there. In 5 years, out of 892 patients nursed at home there were 34 return cases, or a percentage of 4, and out of 725 hospital patients, there were 41 return cases, or a percentage of 5.5. 68 The report of the Medical Officer of Health of Manchester for 1936 contains particulars of that year's return cases in his area. The number of patients discharged from the Manchester Isolation hospitals after treatment for Scarlet Fever was 2,114 and the number of true return cases was 71, a return case rate of 3.4 per cent. It is sometimes stated that the number of return cases bears no relation to season, but with us 7 return cases occurred in the first quarter of the year. |
b17ed7b6-c76f-4409-a0ff-b86a29de8df3 | The number admitted in the first quarter was 92 compared with 362 in the remaining three quarters. It is possible that the enhanced number in the first quanter had some relation to the climatic conditions, and consequently to the over-use of the wards. The wards were not overcrowded in the first quarter, but for some years the first quarter has suffered mostseverely from climatic conditions, and the convalescent patients do not spend so much of their time in the open air as they do in the warmer months. It is known, of course, that overcrowding of the wards will result in an increased percentage of return cases. This is partly if not mainly, due to the greater liability to complications when the wards are overcrowded, and to the possibility of infection by other strains of streptococci to those with which they were originally infected. |
a64bf094-ec0c-4928-9958-c4facbff878d | Our wards were not overcrowded in the stpict sense, and at no time was there less than 144 square feet or less than 12 feet between the centre of the beds during the year. Some authorities state that the number of return cases bears an inverse ratio to the length of the quarantine period, but a lengthened stay in the hospital does not guarantee freedom from return cases. In recent years, there is a growing tendency to reduce the duration of Scarlet Fever patients' stay in hospital. A recommendation was made in the Annual Report of the Chief Medical Officer of the Ministry of Health for 1927, which is now adopted at most hospitals, that in an uncomplicated case, isolation for four weeks is quite sufficient. This does not appear to be known to all medical practitioners, much less to the laity, as letters are received expressing surprise or annoyance from parents and employers when patients are discharged in about four weeks from hospital. |
912a0b2c-bfc9-4b7f-9c30-ba74a193fda1 | The average length of stay in the hospital of the infecting cast would 69 convey no useful infomation and the actual stay of each infecting patient is given, and it was as follows:— 1. 27 days. 2. 30 „ 3. 31 „ 4. 32 „ 5. 32 „ 6. 33 „ 7. 34 „ 8. 39 „ 9. 48 „ 10. 55 „ 11. 61 „ 12. 68 „ 13. 99 „ Nos. 1—7 were clean cases, without any complications while in hospital, but No. 5 had a nasal discharge after going home. Nos. 9, 12 and 13 had Otorrhoea in hospital and on No. 13 a Mastoidectomy was done. The ears had been quite clear for some time before the patient left hospital. |
67935a92-feee-4258-8cd6-dd958637cffb | The others had a nasal discharge whilst in hospital and this complication accounted for the extra length of stay in the hospital. It has sometimes been urged that the return case is dependent upon some abnormal condition of the mucous membrane of the nasopharynx but in seven of our cases, no rhinorhoea or nasal discharge had been noticed in the children during their stay in hospital. In one of the cases, there was a nasal discharge which developed a few days after the patient had reached home. It has been suggested that the return case may be caused rot by a continuance of the original infection, but by another germ picked up in the hospital by the patient. Dr. Griffith, in the ministry of Health's Laboratory, has shown that there are many 70 strains of the haemolytic streptococcus which can be differentiated by certain reactions and identified as they occur in different clinical manifestations. |
c0239f4b-172d-4f45-a052-e394499c42fe | Infection by one strain of haemolytic streptococcus does not protect a patient against infection by another, and the so-called relapse is, probably, a fresh infection by a streptococcus differing serologically from that of the primary infection. Last year we had 10 cases in which a so-called "secondary" rash appeared in most instances after a period of over three weeks after the patiet's admission to hospital. All these cases showed the typical symptoms of Scarlet Fever on admission. Scarlatinal Infection due to different types cannot be differentiated clinically, and it is not possible at present to type all of them bacteriologically on admission. In a Scarlet Fever multiple bed ward it is inevitable that many types of haemolytic streptococci are represented and that therefore cross-infection may occur. Until the extensions to the hospital are completed we can only minimize the risk by ample bed-spacing, and trying to segregate the cases on a Geographical basis in convalescent wards. |
5942672e-9b0c-4cc0-ba4d-eaf06a157270 | Although it is possible that some of the "return" cases may be due to a recent infection with a fresh type, it is not likely that this would explain all the cases. When a probable re-infection occurs in hospital there are certain symptoms which presumably are caused by the re-infection. For instance, it is stated that enlarged glands otorrhoea, and even nephritis, occurring for the first time at least two or three weeks after admission are due to a re-infection by to. different strain of streptococcus. When Otorrhoea, Rhinorhoca enlarged glands, etc., occur after arrival home, it is probable that a re-infection had occurred. But many of these "re-infecting" cases do not exhibit any symptoms which would be presumptive evidence of re-infection. I have enlarged on this subject because it is important to us when planning our extension. |
95fef72c-2ad0-49e2-aba2-65bd5663e3f5 | Theoretically, Scarlet Fever patients should be "warded" in accordance with their types; alternatively, each patient should have his own cubicle. In authoritative quarters, it is held that neither of these remedies is at present deemed to be practicable. A certain number of cubicles are essential but the mostpopular and most highly esteemed block is that in which segregation is based largely on geographical and time considerations. Place of a model ward block so adopted as to enable this to be possible have been drawn up and have been accepted by a number of local 71 authorities, although no block of this type has been erected. Cubicle isolation on this modified plan has been practised by Dr. Lichenstein in Stockholm; he admits to one and the same ward cases coming from a common vicinity or who are infected at approximately the same date, on the assumption that infection may have been with the same strain of organism. |
a1c9a34a-7ad6-4d26-a669-21a0db8e1986 | A Mastoidectomy was done on 12 patients; on one of these the Mastoid on both sides was operated upon; 6 of the operations were done in the first quarter, 2 in the second, two in the third and two in the fourth quarter of the year. A Paracentesis was done on one patient and the Antrum of Highmore was drained in two patients. DIPHTHERIA. 105 cases of Diphtheria were admitted with 5 deaths. Of the total cases admitted, 18 had no clinical signs of the disease on admission, and all the swabs from the nose and throat of these were found to be negative. Of the deaths, one occurred on the day of admission, three on the second day after admission, and the fifth on the sixth day after admission. The ages of the patients who died were:— 4 months, 10 months, 7 years, 12 years and 22 years. |
f3a51c1b-03f4-414f-81ec-2412a927153b | The last had been ill for 12 days on admission. No death occurred in a child who had been previously immunized and as far as could be ascertained only two cases had been previously immunized. MEASLES. 59 cases of Measles were admitted with three deaths. Since the Great War, Measles has appeared in epidemic form in London and most of the district of Greater London every other year, and 1998 was an epidemic year. The epidemic usually makes its appearance in the late autumn months of the "odd" years, reaches its peak in the spring of the "even" and usually continues into the early summer. There will probably be very few cases in 1939, but we may expect some cases towards the end of the year and an epidemic in 1940. 72 CASES ADMITTED TO HOSPITAL. ISOLATION HOSPITAL. |
c0586469-b525-4082-98ac-ee174402fcaa | On April 1st, 1918, the Isolation Hospital was taken over by the Acton and Wembley Joint Hospital Committee. The following is a copy of the Report submitted to that Committee. Patients admitted, 1937—688. Patients admitted, 1938—633. Sc. Fever. Diph. Measles. Ery. Wh. Cough. Impetigo. C.S.M. C.P. Acton 135 25 36 7 - - - - Wembley 300 79 22 2 2 2 1 2 Ealing 'J - - - - - - - Southall 10 1 — — — — — — 454 105 58 9 2 2 1 2 Total—633. Patients Discharged. Sc. Fever. Diph. Measles. Ery. Wh. Cough. |
aaca5c71-d1af-4304-bf41-4e9d4b092e46 | Impetigo. C.S.M. C.P. Acton 143 29 31 7 - - - - Wembley 309 75 26 2 1 2 - 2 Ealing 11 — — — — — - Southall 8 1 — — — — — — 471 105 57 9 1 2 - 2 Total—647. Deaths. Diph. Measles. C.S.M. Wh. Cough. Sc. Fever. Acton 2 3 - - - Wembley 3 — 1 1 1 5 1 1 1 1 Total—11. Patients in Hospital. January 1st 1936-38 Patients in Hospital. January 1st 1939-53 D. J. THOMAS, Medical Superintendent 73 ANNUAL REPORT OF THE School Medical Officer FOR THE YEAR 1938. |
a0f0db54-fb7e-41ca-9a7d-eea6ccf538de | Town Hall, 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 1938. 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. 74 The health of the school children of Acton during 1938 was good. There were few cases of Scarlet Fever and Diphtheria, and the Measles epidemic although it continued for a long time, was mild in character. New cases of Rheumatism and Chorea were slightly less than in 1937. In 1936, it was suggested that the rise which occurred in the number of cases of Acute Rheumatism, was due to the fact that Acton was approaching the crest of a wave of infection. |
73ef8abf-425c-4522-a1b2-1b3e39ccbe2d | It has been pointed out by some observers that the disease occurs in waves, and the figures of 1937 and 1938 bear this out at present. There was only a small increase in the number of cases in 1937, and actually a decrease in 1938. It is to be hoped that cases are now on a steady decline and it will be interesting to see if 1939 bears this out. One of the most annoying causes of school absence in 1938 was Scabies. In spite of all endeavours, cases of Scabies continue to increase in the Borough and in 1938 there were nearly 3 times as many cases as in 1936. Scabies is not a notifiable infectious disease so the. law gives no power of compulsory disinfection of the home, and it is felt that advice as to how to deal with clothing and bedding is ignored, and cases continue to be reported. |
f284b88c-0189-4279-8841-c35e54fff7f8 | The general nutrition of the school children on the whole is satisfactory,—there are of course many cases which have to be helped during the year to attain and maintain a satisfactory standard, but on the whole the average school child is a good specimen. Defects are present, of course, and dental decay is one of the commonest. It is a great pity that as a nation our standard of dental fitness is so poor, and so many adults have false teeth that dental decay is taken by them as a matter of course in the young, instead of being a matter to cause shame and concern. More attention to correct feeding, pre and post natally, would go far to remedy the condition, as dental decay is now regarded by the majority of people, to be in great part a deficiency disease. |
b4950a6e-0cd4-43e0-8474-01b247e5a008 | That so many small children have to attend our dental 75 sessions for extraction of large numbers of their temporary teeth, is disturbing and is a matter which must be tackled first in the person of the ante-natal mother, and continued in the infant and young child. PUBLIC ELEMENTARY SCHOOLS WITHIN THE DISTRICT, WITH ACCOMMODATION. School. Dept. Accommodation. Avge. Monthly No. on Register. Average attendance. Acton Wells Senior 320 207 189 Junior 364 392 353 Infants' 364 190 147 Beaumont Park Senior Girls' 450 133 118 Junior Girls' 450 204 187 Infants' 400 184 156 Berrymede Junior Boys' 640 385 337 Junior Girls' 542 352 317 Infants' 450 281 234 Central 480 379 352 Derwentwater Junior 441 372 340 Infants' 350 339 269 John |
db2ae042-018b-45b5-8aef-b6e9958225e8 | Perryn Senior 360 169 154 Junior 288 236 215 Infants' 336 259 213 Priory Boys' 500 298 265 Girls' 499 279 239 Infants' 400 275 223 Rothschild Junior 450 209 191 Infants' 400 265 219 Southfield Senior Boys' 415 138 128 Junior 382 314 287 Infants' 350 233 195 Roman Catholic 327 255 220 West Acton 300 240 204 Special (M.D.) 68 41 34 10326 6629 5786 76 AVERAGE HEIGHT without shoes, and AVERAGE WEIGHT without clothes. Anthropometric Committee, 1929. Age last birthday. MALES. FEMALES. Height in inches. Weight in lbs. Height in inches. Weight in lbs. |
764467a0-3d2f-44c8-866a-5cfda7016d5a | 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. 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. |
f120695d-28ef-42da-a7f0-755ce96d1f43 | 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. Acton Wells Senior 29 29 58.2 81.9 .... .... .... .... .... Central 49 49 58.7 82.6 .... .... .... .... .... John Perryn Snr. 32 31 57.8 80.9 1 62.3 102.5 .... .... Priory Boys' 120 120 57.9 81.8 .... .... .... .... .... .... Southfi'd Sr. |
4092239f-67c1-4481-a34d-490de478b791 | Boys' 48 46 58. 81.1 2 57.6 74.2 .... .... 94..3 Turnham Gn. R.C. 10 8 55.7 77. 1 59.8 84. 1 62.8 288 283 .... .... 4 .... .... 1.... (GIRLS) Acton Wells Senior 29 29 58.3 80.1 .... .... .... .... .... B'm't Pk. Sn. Girls' 55 52 58.6 83.7 3 59.8 92.5 .... .... Central 51 51 58.3 82.3 .... .... .... .... .... John Perryn Snr. 29 29 59.3 84.5 .... .... .... .... .... Priory Girls' 99 98 58.3 85.7 1 59.3 80.8 .... .... Turnham Gn. |
d4431736-7b65-4987-bea2-a0b2535dee65 | R.C. 10 7 58. 83.7 3 61.4 84.1 .... .... 273 266 .... .... 7 .... .... .... .... 77 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. (???)Wells Junior 28 18 50.9 57.8 10 50.3 56.3 ... ... ... (???)Wells Infants' 22 11 47.9 51.1 11 49. 54.9 ... ... ... (???)Park Infants' 2 2 51.3 56.2 ... ... ... ... ... ... (??? |
1997ce05-22fe-49ee-9528-d33b593b9b34 | )Junior 97 65 49.1 55. 30 49.5 55.9 2 54.3 72.3 (???)Infants' 6 6 49.2 55. ... ... ... ... ... ... (???)Junior 51 26 49.8 57.1 24 50.6 56.5 ... 58. 70.5 (???)Infants' 9 8 47.9 51. 1 48.8 53.3 ... ... ... (???) Junior 2 ... ... ... 2 52.7 66.7 ... ... ... (???)Infants' 36 20 49.9 56.5 16 50.4 57.1 ... ... ... (???)Infants' 4 3 47.6 48.8 l 47. 56. ... ... ... (??? |
3a11b0a6-c707-4965-ada9-ea10b619114c | )Junior 47 27 50. 58.2 20 49.7 56.7 ... ... ... (???)Infants' 8 8 47.9 53. .... ... ... ... ... ... (???)Junior 45 13 49.3 55. 32 49.5 57.1 ... ... ... (???) Infants' 9 9 50.5 57.7 ... ... ... .. ... ... (???)Green R.C 21 5 52.1 61.3 13 49.4 53.9 3 52.5 56.6 (???)Acton 30 8 49.5 52.4 22 49.9 56.3 ... ... ... 417 229 ... ... 182 ... ... 6 ... ... (GIRLS). (???) |
d5d56f53-53ed-4bb8-a55b-20406cad2e4b | Wells Junior 13 10 48.1 51.1 3 49. 50.3 ... ... ... (???)Wel!s Infants' 17 9 48.7 49.9 8 49. 53.1 ... ... .... (???) Pk. Inr. 46 25 48.6 53.2 21 49.9 57.6 ... ... ... (???) Park Infants' (???) lunior 1 1 51.8 66.5 ... ... ... ... ... ... 77 41 48.6 54.2 34 48.9 53.4 ... 51.2 73.4 (???)Infants' 2 2 47.5 51.3 ... ... ... ... ... ... (??? |
79b5e2a5-e23c-4e90-9107-1c528e996fde | )Junior 48 21 49.6 55.1 27 49.5 53.5 ... ... ... (???)Infants' 6 6 47.8 52.7 ... ... ... ... ... .... (???)Perryn Junior 3 ... ... ... 3 50.4 58.3 ... ... ... (???)Infants' 36 12 50.9 54.9 24 50.1 56.2 ... ... ... (???)Infants' 4 4 48.6 47. ... ... ... ... ... .... (???) Infants' ... ... ... ... ... ... ... ... ... ... (???)Junior 39 15 47.5 52.6 24 50.7 55.7 ... ... ... (???)infants' 9 9 45. 56.2 ... ... ... ... ... ... (??? |
4bd976ce-73aa-440e-9698-0a03d59db4de | )Green R.C. 15 5 47.3 48.6 7 50. 53.6 3 52.9 61.6 We Action 21 5 48.9 50.5 16 49.2 54.7 ... .... ... 337 165 ... ... 167 .... ... 5 .... ... 78 TABLE SHOWING HEIGHTS AND WEIGHTS AT DIFFERENT AGES. ENTRANTS (HOYS). No. Examined. Years op Age. 3—1 4—5 5—6 0—7 No. Height ins. Weight lbs. No. Height ins. Weight lbs. No. Height ins. Weight lbs. No. Height ins. Weight lbs. |
60b82781-0e5f-41b0-a3d2-612f13eefe5a | Acton Wells Infants' 30 3 38.2 35.5 13 41.3 40.3 13 44.5 43.6 1 47.8 48.3 Heaumont Park Infants' 41 19 37.7 34.9 5 41.9 41.2 13 42.7 41.5 4 46.5 49.7 Berrymede Infants' 62 25 37.9 36. |
9cceb4c3-31a5-4320-90f6-ad537922d0c7 | 20 40.6 38.4 12 44.1 45.4 5 45.4 50.2 Derwentwater Infants' 68 .... ... .... 40 41.1 38.9 21 43.8 40.3 7 46.6 48.3 John Perryn Infants' 17 ... ... ... 4 41.2 37.9 11 44.1 43.5 2 45.6 45.8 Priory Infants' 64 20 37.9 33.7 20 41.2 40.7 16 43.8 44. |
870edc21-b3ce-4fae-acdf-9e3e3e28fb2a | 8 46.7 47.5 Rothschild Infants' 49 20 37.6 35.3 12 39.9 39.8 13 42.2 41.4 4 46.1 49.5 Sou fh field Road Infants' 39 .... ... .... 19 40.6 37.8 15 44. 42.4 5 45.9 47.2 Turnham Green R.C. 18 .... .... .... 5 41.6 38.9 8 43.5 40.3 5 46.2 46.5 West Acton 30 8 30.2 34.0 12 42.1 40.8 9 44.7 40.9 1 43. 38.8 418 95 ... 150 131 42 (GIRLS). |
3750ad2f-2003-41ad-970f-da553575eb28 | Acton Wells Infants' 28 4 37.7 33.0 5 40.6 38.8 16 42.1 41.1 3 44.5 43.8 Heaumont Park Infants' 23 10 36.2 32.0 6 41.2 38.8 6 42.3 41.1 1 43. 41.3 Berrymede Infants' 55 24 37. 32.9 14 40.4 39.2 13 41.9 40.1 4 46.2 49. Derwentwater Infants' 68 .. ... ... 24 41.4 38.0 38 43. 42.7 6 45.8 46.1 John Perryn Infants' 34 ... ... ... 10 40.9 38. |
4c63e045-ca57-4734-b5d7-17d42b3b41be | 10 43.6 41.6 8 47. 49.2 Priory Infants' 48 10 37. 33.1 13 40.2 37.4 14 42.9 41.1 5 44.5 45.3 Rothschild Infants' 48 23 37.6 33.0 11 40.8 39.7 10 42.9 43.8 4 45.G 50.3 Southfield Road Infants' 45 ... .... ... 17 41.2 38.8 21 43.5 41.1 7 45.8 40.5 Turnham Green R.C. 24 ... ... ... 8 40.0 37. 9 43.1 40.7 7 44.8 45.1 West Action 29 7 37.8 32.3 7 40.3 32. |
ed3bd1d5-95ef-45bf-907c-6679b4f8ab16 | 1 11 43.2 41.8 4 46.8 46.9 202 84 115 154 1 79 TONSILS AND ADENOIDS. In 1938 much discussion took place in various medical papers on the subject of Tonsillectomy in children. Dr. Glover, in a paper given before the Royal Society of Medicine, gave most startling finures for the incidence of the operation in different parts of the country. He pointed out that the operation was a comparatively rare one before the present century, although it is difficult to get reliable figures for tonsillectomy in children before the onset of the School Medical Service with its subsequent grants for treatment, and therefore available statistics. The number of school children operated upon for the removal of tonsils and adenoids, rose rapidly to reach its maximum in 1931. It then fell from 1932 to 1935 and is now rising again. |
98408a2e-17db-4084-84b4-8d90359034e3 | The figures for tonsillectomy in Acton at these periods is given at the end of this article. It is difficult to find an explanation for the spectacular rise in the rate of operation, and equally difficult to explain the different percentages of children operated upon in various parts of the country. It was pointed out that a child living in one Borough was 20 times more likely to be tonsillectomised than one living in a neighbouring Borough, and that two suburbs of London with comparable child populations differed enormously in the numbers of their children who had their tonsils removed. It was not observed that the children in the suburb where few operations were performed, suffered in comparison with their neighbours from what might have been expected as a result of non-operation, i.e. otitis media, deafness, enlarged glands in the neck, or rheumatism. |
2979258e-3eac-4a43-adb8-8887e375f60b | These facts require some explanation, but until definite criteria are laid down as to what constitutes disease of the tonsils, the question of their removal will always remain a matter of opinion, and as such, divergent results will always be obtained. It has been said that three attacks of tonsillitis in one year, or two attacks accompanied by growing pains, are indications for operation. It has also been said that gross enlargement accom(???) by interference with hearing and marked nasal obstruction indications. Removal of tonsils is also necessary should the child ever have suffered from quinzy. These factors must, however, be correlated with observations and notes made at the time examination, i.e., 1—The age of the child must be taken into consideration. At certain ages, 5 to 8, there is a physiological enlargement of the tonsil consequent upon rapid growth and the meeting of "herd" 80 infections at school as against the ordinary home infections. |
b96288fd-9d1e-4d62-8937-a7f6d508908e | Is the enlargement so often met with at those ages due to the rapid growth of all the bodily structures of the child, or is it due to a protective activity of the body in putting up a defence to the new infections the child is meeting? It has been pointed out that the majority of tonsillectomies are performed between the ages 5 to ft, and it is possible that many tonsils are removed which might be left in situ without detriment to their owner, and which would subside as a natural development in the next few years of life. 2—The oral and nasal hygiene of the child. It is possible to have enlargement of the tonsillar gland or of the glands of the neck from sepsis in the child's teeth or in its nasopharynx. |
38cdb368-21cd-4d10-9a0e-f8af69feb9b9 | If a child has very badly decayed or septic teeth, if it has a persistent post-nasal discharge from badly infected nasal sinuses, it is conceivable that an attack might be made on the overworked and overloaded tonsil as the culprit, while the causal factor escaped observation. It is not possible at routine school medical inspections to examine exhaustively all a child's nasal sinuses, and it is equally difficult to ensure that advice given to a parent to enable such sinuses to clear themselves is followed, and the position is thus made no easier at a subsequent examination if the advised treatment has not been followed, and the source of the infection may still remain in doubt. 3.—The history obtained from the parent. These are by no means always reliable, and many people have no idea what really is meant by an attack of tonsillitis. To accept their statements sometimes means believing that a child has had 20 to 30 attacks of tonsillitis in an incredibly short space of time. There is also (???). |
f34faa78-e0aa-48fc-9782-f9221f682e19 | difficulty so often met that someone has told the mother that the child's tonsils are bad, and from that idea she will not move. the mother who is determined by hook or by crook to have her child § tonsils out, is not uncommon, and it is preferable for her to believe that something spectacular in the way of operation is needed, than to credit that ordinary nasal hygiene and some dental attention will be sufficient. The mother who will not countenance operative measures at all is also met with, and it is a fact that events often prove her to be right in refusing. At puberty there is a normal natural shrinking of such structures as the tonsil, and if operation caij be avoided until then, it is often the case that there are no indications for operation left. |
096e4f9d-eb78-4523-b0b6-1c0a21871abe | If every case put forward for tonsillectomy were considered carefully from all these points of view, and none were operated upon immediately, but only after a considered period-say 3 81 months—during which local treatment to the nose and its accessory sinuses and to the teeth, were persisted in, it is possible that tonsillectomy would again take its place as a rare operation. It is proposed in Acton to pursue for the future the regime outlined above wherever it is possible. A Nose Clinic is being established in which all cases for operation will be treated, and no case will be allowed to go for operation until its teeth have been attended to. A certain number of cases which are operated upon through our School Medical Service are referred to that service for operation by various hospitals, etc. but unless a special reason is alleged, these will be treated in similar manner. The practice advocated by Mr. |
fa3f5304-354b-43df-9ab7-fe7cd66e12c4 | T. B. Layton of Guy's Hospital, will also be adopted in refusing all Tonsillectomies during the winter. It is naturally in the winter that enlargement may be present which is due merely to the common cold, and sore throat from common cold is not synonymous with tonsillitis although many mothers find it difficult to distinguish the two. Common colds have never yet been prevented by the removal of tonsils, and it is better that a child should recuperate at a time of year when common colds and other more serious infectious diseases are less prevalent. During 1938 in Acton, 41 operations for Tonsillectomy were performed and 3 cases were operated on for removal of Adenoids only. Of these cases, 23 were referred through the school medical service in the first instance, and 21 referred for operation through our service by various hospitals, i.e., Mr. Griffiths, Ear Consultant at the Acton Hospital, referred 12 cases, Dr. |
801956f9-df01-4ac1-bc4b-e318a29dc13e | Nicol Roe the Tuberculosis Officer referred 3 cases, Brompton Hospital referred 3 cases, Golden Square Hospital referred 2, and the Princess Louise Hospital referred one case. 30 cases had their tonsils and adenoids removed because of repeated attacks of tonsillitis accompanied by enlargement of the cervical glands, 5 cases were operated on because of their chest conditions and cervical gland enlargement, 1 case was operated upon because of persistent ear discharge, one child who suffered from rheumatism was recommended for removal of septic tonsils, 3 children were operated on because of excessive enlargement of the tonsils with mouth breathing and slight deafness, one child was operated on following an attack of tonsillitis with quinzy. 2 children had adenoids removed because of slight deafness, and improvement followed the operation. One child was operated on for the removal of a large lump of adenoids which had been Partially detached at a previous operation and which was blocking the child's nasopharynx. |
e6f9cafe-cb78-4758-92eb-8ba8779dc17b | 82 Figures for Tonsillectomy in Acton. Aural Surgeon appointed in September, 1918. Operated, on through the Authority's Scheme. Operated on Privately. 1919 189 11 1920 279 36 1921 120 15 1922 67 31 1923 35 15 1924 — 31 1925 118 25 1926 173 13 1927 196 13 1928 183 20 1929 202 37 1930 232 17 1931 160 26 1932 59 5 1933 47 4 1934 38 2 1935 77 6 1936 47 5 1937 43 3 1938 44 RHEUMATISM. |
7d52f505-e9a4-4f43-bcb4-1a4c581f3797 | Acute Rheumatism in childhood continues to be a potent source of ill health both at the time of infection and in its subsequent effects on the heart. In 1938 Acton again had its quota of children suffering from acute rheumatism or chorea to be noted, and a number of relapses to record in children who had previously suffered from acute rheumatism. Rheumatism in its first attack may not damage the heart, but each subsequent attack renders the patient more liable to injury and permanent damage may be done. As pointed out in previous annual reports, it has been held by some specialists in dealing with acute rheumatism in childhood that a period of convalescence in a heart home of at least one year after the initial attack may lessen the risk of subsequent attacks and so lessen the risk of permanent heart damage. |
c83fd99f-e78a-4295-9a68-7841b195a7dd | It has also been 83 held that with adolescence the risk of relapse becomes less and that if rheumatism can only be held in check until then, there is a fair chance of the child growing into a healthy adult. The child who then develops acute rheumatism or chorea when 5 years old has more years of anxious watching to meet than the child who has its initial attack when 9 to 11 years old. All children who had, or have had, rheumatism will have to be watched for the rest of their school days, and for this purpose local authorities have established rheumatic clinics. Here, these children are examined periodically and all necessary steps for safeguarding them are undertaken. Our rheumatic clinic is attached to the Princess Louise Hospital for Children, where Dr. Aitken sees our cases and advises on treatment. During 1938, 12 new cases of • rheumatism came under observation, 7 cases of acute rheumatism, and 5 cases of chorea. |
cf0c3536-a2d1-44e8-a7b5-da5e52f0692e | Of these 12, 2 were treated for the original acute attack in the Central Middlesex Hospital, 1 in the Ealing General Hospital, and 2 by their own doctors at home. 3 cases were discovered at school inspections to be attending the Princess Louise Hospital Rheumatic Clinic and the remaining 4 were discovered by the School Medical Officers and referred to the Princess Louise rheumatic clinic. The ages of these 12 new cases ranged from 5 to 11 years and in no case except 1 was there permanent heart damage as a result. The one case mentioned is still in Hospital so it is too soon to tell. 28 old cases of rheumatism were kept under observation in 1938, 21 of these went through 1938 with no relapses and are attending school in a satisfactory condition. 7 cases however showed relapses of varying degrees of severity. |
7b46e9fd-6e86-40e5-b5dd-8bebbbbe63c4 | One of these cases was in hospital at the end of the year, one is in the Edgar Lee Heart Home, one is in the Heart Home at Lancing. 2 children were discharged from the West Wickham Heart Home after a period of convalescence following the relapse and one was discharged in a similar manner from the Heart Home at Lancing. One child whose relapse is very slight, is attending the Princess Louise Hospital regularly and being kept under observation. In 2 of these cases, last year's was the third attack of acute rheumatism and one of these children is now only 8 years of age. it will be some time before adolescence comes to his rescue with its lessened tendency to relapse. He is fortunate in that the damage to his heart up to date is negligible, and should he escape further damage will in no way lessen his efficiency as a worker when he grows up. It was pointed out by Dr. |
24ff532a-ed0c-489d-9452-016abfa2ed90 | Schlesinger in the work he did at the West Wickham Heart Home, that attacks of tonsilitis 84 tended to cause relapses, and as this boy has now had his tonsils removed it is to be hoped that the future will hold for him a greater resistance to infection. 2 cases were referred to the rheumatic clinic as being suspect cases of rheumatism, 1 child was suspected of chorea and the other of a mild attack of rheumatism. Both children had rheumatic family histories and therefore were suspect, but the attacks were abortive and the children are meantime well and in a satisfactory condition. ASTHMA. |
b1e377cb-fba1-4632-aee0-41b8adee5281 | 8 cases of Asthma came under observation in the year 1938 and 3cases of Asthma were associated with Eczema of the skin Of these cases, one has been in a Home at Broadstairs for 6 months and is still there, one was in a Home at Worthing from February until September when he came home as being much improved As soon as he came back to London his Asthma restarted and he is meantime awaiting admission to the same home. 3 other cases of Asthma are waiting admission to convalescent homes. 3 children are attending ordinary elementary schools, 2 of these are now having very slight and infrequent attacks, and 1 after a pro longed holiday in Somerset is now fairly free from attacks. Of the 3 cases suffering from Asthma and Eczema, 2 are time fairly well, with skins rough but healed, and very little Asthma. The third suffers less from Asthma but his skin is not yet healed. |
1d1257f6-023e-480d-a78a-c4918573c92a | Attempts were made to get the latter boy to(???) in Switzerland through the Queen Alexandra Fund, but there was no vacancy and not likely to be one for some time. The boy' name has been taken by the Secretary but there is not much hope of getting him to Switzerland. Asthma is a disease due to a hypersensitivity on the part of the sufferer to something in his environment or diet .the tendency is hereditary, and in the same family are often found other sensitisation diseases such as Hay Fever or Urticaria. the cause may be anything from the dust in the air the person breai(???) to the food eaten at any meal. Cure is often wrought by(???) to a different environment, by tracing the articles in the dret which bring on attacks, or by desensitising injections given over 2 long period. |
65e311fc-fa34-4f12-8790-79739f701420 | In Cardiff there exists a special Asthma clinic whose immense trouble is taken to investigate each patient and to fiend out to what substances he is sensitive. Breathing exercises are also taught and the results of these exercises show that clinically cured and another 50% improved. It is a 85 fact that breathing, which is a most vital function of our bodies, is so often performed badly, and that perhaps for days, weeks or months the lungs of a person living a sedentary life may never be fully expanded or air drawn into all the air spaces of the lungs. The figures of the Cardiff clinic of improvement and cure in Asthma from regular breathing exercises are most impressive, and the Medical Superintendent of the Clinic reports that the majority of patients, having learned to breathe properly can prevent an attack of Asthma progressing, by using the exercises. SCARLET FEVER. There were fewer cases of Scarlet Fever in the school population in 1938 than in 1937, there being 108 cases as against 134. |
c911577e-7ed9-46a4-95cc-fdc58ba6b651 | The usual autumn rise in the numbers of Scarlet Fever cases did not materialise, in fact towards the end of the year there were fewer cases of Scarlet Fever about than during the summer (so-called) and the cases which did occur were of a very mild type. Few complications occurred and fewer cases of otorrhoea were noted generally, both in hospital and in the school population. When there is Scarlet Fever about, there will always be a certain number of cases who do not develop a Scarlet Fever rash, but in whose throats the causative organism may be found. These cases are not suspected by their families, are not reported, and are the cause of the regular cropping up of cases of Scarlet Fever throughout the year. It is not practicable to isolate every child whose throat condition on examination is such that it may be harbouring temporarily the organism of Scarlet Fever, and it is only after a case or two has occurred in a classroom that steps are taken to try to isolate the possible carrier. |
e4c9053e-4c4b-49ad-8df3-9f7f10b6ef5e | The organism of Scarlet Fever is so ubiquitous and may find a temporary lodgement in so many throats without giving rise to symptoms of the disease, that to try to stamp it out in that way is an impossibility, at any rate in a town. Immunisation against Scarlet Fever in the same way that it is performed for Diphheria is not a practicable solution either. The immunity conferred does not last more than a few months and protection would mean continual re-inoculation. The distribution of the cases in the schools was as follows: — Acton Wells 13 Beaumont Park 27 Berrymede 10 Central 2 Derwentwater 16 John Perryn 7 Priory 7 Rothschild 11 Southfield 7 West Acton 8 Roman Catholic — 86 In 6 schools the numbers had fallen and this decrease was particularly noticeable in South Acton. In Berrymede and Priory Schools in 1937 there were 36 cases. |
3c8f67a2-aa28-4a7b-ad72-f9fb6eb6396a | In 1938, only 17. In Rothschild and Beaumont Park Schools, on the other hand, the number rose from 30 in 1937 to 38 in 1938. John Perryn School in 1938 had 7 cases against only 1 in 1937. Acton Wells School had exactly the same number as in 1937, but West Acton School showed a drop from 14 to 8. Derwentwater and Central Schools had 18 cases in 1938 as against 20 cases in 1937. There were no cases at all reported from the Roman Catholic School in 1938 and there were 3 in 1937. Southfield School had 15 in 1937 but only 7 in 1938. 103 Scarlet Fever patients and 135 contacts were examined at the Town Hall before resuming school attendance. Contacts are allowed to attend school if found to be alright and are kept under observation. |
5e1e328a-5fac-400c-b9c1-1b1b17cc0c8f | The exclusion of contacts was formerly done on the assumption that they were incubating the disease and wencapable of infecting others. It is the exception rather- than the rule to have another case in the family as the child, if ill, has probably been kept apart. It is after the return of the patient from hospital that the danger arises, for it is then that the child, convalesceni and allowed to mix with the others as much as it wants, is mort likely to pass on the organism to its brothers and sisters. It is impossible to guarantee that any child discharged from hospital after Scarlet Fever has not got some of the organisms still in its nose and throat. As mentioned before, the organism is ubiquitous and the advice given to parents to keep the patient apart for atleast a fortnight, is seldom carried out. Fortunately, for many years now, Scarlet Fever has been of a very mild type, and is an infectious disease which at the present time gives rise to little anxiety. DIPHTHERIA. |
50c6f4cf-ce91-4e9b-8579-2266499529ed | 1938 was a year nearly free from Diphtheria in the school population. There were only 9 cases during the whole year Unfortunately, one of these 9 cases died, a little girl—an only child who had not been immunised against the disease. It is unfortt that it seems impossible to convince people that immunisation vC a good thing, and it is not until it is too late that some means awake to a sense of their responsibilities, and regret, with unavar ing bitterness, their obstinacy and carelessness. 87 It is gratifying to be able to report however, that in our infant schools, the percentage of children inoculated has risen, and that in two schools it is over 60%. The figures are given below and the percentages for 1936 are given for comparison. 1938. 1936. |
d4cfed32-9a9b-4c4f-81fd-a69c60b1b95a | Acton Wells 52.6% 43.5% Beaumont Park __ 61.9% 42.6% Berrymede 26.1% 33.7% Derwentwater __ 44.4% 45% John Perryn 59.8% 40% Priory 43.2% 37% Rothschild 56.6% 31% Southfield 50.2% 37% West Acton 67.9% It will be noted that in nearly every case the percentage has risen, and this augurs well for the possibility of freedom from Diphtheria in the next year. It will be seen from the above table that Berrymede School which serves the most crowded part of the Borough, i.e. South Acton, is the school with the poorest percentage of immunised children. It is also the school from which 4 out of the total 9 notified cases of Diphtheria were drawn. |
e33d110d-b17f-4a3c-9743-bf948148a0bd | It is the most difficult school from which to get consent from the parents for inoculation to be performed. At medical inspections it is waste of time to try to reason or explain the dangers which might so easily be avoided by simple injections. The parents "don't hold with it" and that is that, no argument is of any avail against blind assertion unbacked by any facts or knowledge. The schools at which Diphtheria occurred during the year were:— Acton Wells 1 Beaumont Park 1 Berrymede 4 Rothschild 1 Southfield 1 (died) Roman Catholic 1 88 Two of the children who developed Diphtheria had been immunised, one 5 years previously, and one the year before. Both had mild attacks and their condition never gave rise to anxiety. Our immunisation scheme against Diphtheria was conducted on similar lines to former years. |
09469321-4fd8-48d8-98a4-4012dcbb2f4e | Immunisation is offered to children in their pre-school years at Infant Welfare Centres, and again to all school entrants. The necessary injections are carried out, and after an interval of 6 months the children are Schick tested and those found. to be positive are re-inoculated. It was not found that any child required more than one injection after the Schick test, to turn a positive reactor into a negative one, and therefore in future it is proposed to drop the Schick test altogether and substitute for it, in each case, another injection of immunising material. The Schick test is not a reliable test of the level of immunity created in the blood, and it is a much greater ordeal for the child than an injection. It is not thought, therefore, that any child will suffer by the substitution, but that the immunity in a great many cases will be heightened. |
7cf023a0-e7bb-4c0f-ae96-95a151b3c494 | The immunity so conferred can be reckoned as lasting approximately three years, so it is our custom to offer to all immunised children another injection every three years during their school days. This stirs up the waning immunity in the blood and keeps the child reasonably safe from contracting Diphtheria. It is claimed by those who oppose Diphtheria Immunisation, that to be immunised may prevent a child succumbing to the disease, but will not prevent him from harbouring the germ in nose or throat. Each such child, or carrier, is a potential source of danger to others, and each immunised child may be looked upon as suitable soil for becoming a carrier. We thus are, by immunisation, enormously enlarging the field of potential Diphtheria carriets and laying the whole unprotected population open to catching the disease from such people. |
7f7d4298-2369-45f3-a9d1-21b4063beb8d | There is no proof that this actually happens, and ample proof to those who care to look, that immunisation must have saved the lives of thousands of children Since immunisation started in Acton, there has not been one death in a fully immunised child—the statement must be expressed thus, as it may take anything up to 6 months after the last injection before the immunity in the blood has reached a satisfactory level 10 Diphheria patients and 22 contacts were seen at the office before returning to school. 89 (???) school. Positive Negative 1st. 2nd 3rd 1st. 2nd after 3year Acton Wells Senior __ 10 Acton Wells Junior 6 4 — 1 3 6 10 66 Acton Wells Infants — — — — l 49 40 16 Beaumont Pk. Senior Girls 4 3 1 1 l 1 — 1 Beaumont Pk. Junior Girls 1 — — — — |
d77dd561-a703-4d6e-97a8-5f07f69d84b4 | 1 — 10 Beaumont Park Infants — — — — — 30 34 9 Berrymede Junior Boys — — — — 2 5 7 22 Berrymede Junior Girls — — — — — 2 2 16 Berrymede Infants — — — — 1 30 22 1 Central 1 — — — — 1 — 12 Derwentwater Junior — — — — — 3 2 27 Derwentwater Infants — — — — — 40 37 17 John Perryn Senior — — _ — — — — 5 John Perryn Junior — — — — — — — 31 John Perryn Infants — — — — — 25 23 25 Priory Boys — — — — — — — 2 Priory Girls — — — — — 2 1 3 Priory Infants — — — — 1 63 48 12 Rothschild Junior — — — — — — — 17 Rothschild |
1f6098eb-9ad4-4eb3-9877-849b55c0305b | Infants — — — — 2 48 42 4 Southfield Senior Boys — — — — — — — 1 Southfield Junior 3 — — 1 1 28 24 30 Southfield Infants — — — — — 51 42 5 Roman Catholic — — — — — 25 20 2 West Acton 1 — — — — 64 60 24 , Hospital — — — — — 46 41 Welfare — — — — — 249 232 — Others 1 — — — — 1 1 2 Total 17 7 1 3 12 766 700 370 In addition 604 were Schick tested after inoculation, and of this number 129 were Positive and were given another dose. 90 MEASLES. 1938 was an epidemic year for Measles, but the (???) |
85623084-91ad-4470-95af-945a1e55f2d8 | although long drawn out, was mild in character and did not present the number of ear complications,—otitis media and mastoi(???) that the 1936 epidemic did. On the whole, the disease was mid and although several deaths occurred, there was no death in a child over 5 years of age. It is in the early years of life that Measles is such a deadly children's disease, and if a child can escape catching it until he has reached the age of 7, there is less danger to life and much more likelihood of the child's escaping with a mild atrack of the disease. Measles has occurred in Acton with regularity every two years for the last 30 years. It is an interesting epidemiologcal problem to consider the why and wherefore of this. |
ed743c1b-463a-4ed3-beeb-e734186dc961 | It has been suggested that in addition to those who contract measles and thereby develop a life long immunity to the disease, there are three who develop a temporaiy immunity by getting subclinical dosen of infection during an epidemic. The epidemic dies down when the percentage of children who have not got either a temporary or a permanent imi(???) falls below 20%, and breaks out again when the percentage has risen again above 25%. The causative organism of measles (???) far unidentified, and the only preventive treatment at our (???) consists in the administration of serum from human beings who have had in the past, or who are at present convalescing from the disease. Exclusion of contacts from the Infants Departments only is practised. It is, as has been said, in the early years of like measles is a serious complaint, and a large proportion of children in the junior and senior departments of our schools wil allready have developed an immunity to the disease. EXCEPTIONAL CHILDREN. |
dbbd28b4-24c9-4e3f-8842-8c4ec5c6c2e9 | Blind and Partially Sighted. 1 child attends a certified school for the Blind to which the ^ was transferred last year. 1 child attends the Kingwood rood School for Partially Sighted, and 1 child is at present(???) an ordinary elementary school because he is not yet old enough to attend a special school for the partially sighted. 91 Deaf. 4 children are attending special schools for the deaf. attend Ackmar Road School, 1 is at Oak Lodge, and 1 is at Anerley Residential School. 2 children, both deaf and dumb are at present attending ordinary elementary schools until they are old enough to go to special schools for the deaf. Mentally Defective Children. There are 42 children at present attending our Special School {or Mental Defectives. During the year 10 new admissions were made, 2 were sent to Ealing Occupation Centre as ineducable. Epileptic Children. |
1e111cd3-d903-434f-be56-083b44120fcc | 2 children are in epileptic colonies, one at Lingfield and one at Chalfont St. Peter's. 1 child is being allowed to attend an ordinary elementary school as she suffers from petit mal and the Attacks are very slight and infrequent, and one child, recently moved to Acton, is waiting admission to an epileptic colony. Tubercular Children. 2 children are suffering from Tuberculosis of the lungs. One in Brompton Hospital and the other in Harefield Sanatorium. children suffer from non-pulmonary tuberculosis. One is in the Treloar Home at Alton and one, after being operated upon in the Central Middlesex Hospital, is at present in a convalescent home if Worthing. delicate Children. 14 children are included under this heading. 3 of these children are attending the Wood Lane Open Air School and 2 are waiting admission to the school. 3 children are attending ordinary mentary schools and are being kept under supervision. |
29f235ea-300f-416d-91c8-0b97e455eda5 | 1 child is waiting admission to a residential heart home, he has been away before and recently has been losing ground and is to go away again meantime he is attending the ordinary elementary school. children are in Homes at Broadstairs, 2 boys suffering from Asthma are waiting admission to residential convalescent homes, and one child is at home waiting admission to a residential con- ascent home as a result of repeated chest trouble. 92 Crippled Children. 1 child is at a certified P. D. School (Queensmill Road School), 1 child is in hospital having had repeated operations on her leg, and 1 child is at home. She has been recommended to attend a school for physically defective children later on. She has had bone grafting operations performed on one of her legs and ft not considered suitable for an ordinary elementary school. Children with Heart Disease. 2 children are at special heart homes, one at Lancing, and one at the Edgar Lee Heart Home. |
aca8b166-1ad0-49db-909e-f1add035f8fa | 2 children whose hearts were affected by Rheumatism are attending ordinary schools but are being kept under observation at the rheumatic clinic, and 1 child . is being treated by his own doctor for heart disease following rheumatism. Multiple Defects. There is one child who has recently moved into Acton who is deaf and dumb, partially paralysed, is said to suffer from fits and possibly is feeble-minded. She is meantime in Acton Hospital undergoing an operation, but has been recommended for a residential school under the L.C.C. REPORT OF THE EAR CLINIC. 73 cases attended the Ear Clinic during 1938. 61 were treated for Otorrhoea (ear discharge). 4 had earache,—3 due to inflammation of the middle car and subsided, and 1 due to a boil in the ear. 2 were deaf. 2 had wax in the ears. 1 nothing wrong with ears. 3 had external otitis, were treated and cured. |
f9b8644c-188f-4960-ac98-b1cd4ec60eb0 | 61 cases of Otorrhoea. 44 of these cases suffered from acute attacks of otorr(???) and 3 of those 44 suffered from two attacks during 1938. 47 cases of acute ear discharge treated at the Clinic. 17 of these cases cleared up in a week from the beginning of treatment. and 15 more had cleared by the end of the second week. 4 cases 93 three weeks to clear up and 3 cases took a month. 1 case took six weeks in which to clear up but attendance here was very irregular. In 1 case the time could not be determined as the holidays intervened, and the child did not attend during holidays. The ear was, however, better when school reopened. One child refused to attend our clinic, one preferred to attend her own doctor, ind one had to be referred to hospital for operation on her mastoid process. The remaining three cases were all recent cases and were still attending the Clinic at the end of the year. |
1bcfca45-159e-4adf-b2fd-8a93beed2f06 | The person who suffers from chronic ear discharge is much more difficult to treat and responds much less readily to local treatment. It is often difficult to decide whether the ears will clear up with local treatment or whether resort to operation will be necessary. There are children who, whenever they get a cold in the head, develop ear discharge which ceases as the cold clears away. Each attack, of course, makes the condition of the ear just a little worse as regards hearing, but there is no guarantee that, even after operation, these children will not get ear discharge just the same with each head cold. There is one case attending our Ear Clinic at intervals with discharge from both ears, and this child had, in order to clear up her original attacks of otorrhoea, both mastoid processes operated upon. Still, with every head cold, this child gets from both ears discharge which is most obstinate and difficult to treat. |
d7856eed-c20f-4d5d-ba0c-39a67a1362ff | She has now been referred to our new Nose Clinic and her nose and nasopharynx are to be subjected to regular courses of treatment to try to prevent the child developing colds and so getting further attacks of otorrhoea. There are 17 cases of chronic otorrhoea who have been treated in 1938, a fair proportion of these (9) were treated for otorrhoea in 1937 and one has been treated each year since 1935 for otorrhoea,—a perfect example of ear discharge following a winter cold in the head. 4 cases were very resistant to treatment and the ear discharge continued for weeks before clearing up. 1 case was referred to the Ear Specialist at Acton Hospital as he resisted treatment (he also had previously been operated on) and - cases were still attending the Ear Clinic at the end of the year. 5 cases of Earache. |
800d4e86-e776-4f84-9451-c0e4100b23cd | 3 of these were due to inflammation of the ear, 1 was due to a boil in the ear, 1 was due to a slightly inflamed throat. All subsided with treatment. 94 4 cases of deafness. 2 cases were due to wax in the ears and cleared up after its removal. 1 was due to a foreign body in the ear and cleared up after its removal, and 1 was due to a slight inflammation d the ear during the course of a head cold, and disappeared with the cure of the cold. 3 cases of External Otitis. It was difficult at first to tell what was the extent of the trouble, and swelling and scabs of Impetigo made it impossible to see into the ear, but on treatment to the outside Condition, the drum was found to be unaffected in each case. 1938 has been fortunate in being a year with comparatively little Scarlet Fever. |
0aa5ab4b-1cc8-4f4b-bfd4-7dfe189fdd3a | The usual expected Autumnal rise did not materialise to any extent, although during the summer cases Scarlet Fever were cropping up in unexpectedly large numbers the time of year. With the absence of the Autumn rise ho there was absence of those sore throats, etc., which do not bec clinical Scarlet Fever. We are inclined to attribute the ease which so many of our cases of otorrhoea cleared up, to the that the organism of Scarlet Fever was not so ubiquitous as and it is notoriously those cases due to the organism of Scar Fever which are so difficult to clear up. In comparing the number of cases of otorrhoea in 1938 those of the previous year, i.e., 61 with 63, there is very difference, but it was found much less difficult to clear up the of otorrhoea in 1938 than it was" in 1937. The Ear Clinic has been conducted along the same as before. |
00ddeb8a-3a59-4e09-bb7c-c5bbec85836d | Each case has been seen each school day by the Medical Officer or the nurse, and appropriate undertaken. SCABIES. Scabies continued to infect the school population in 1935 even greater numbers than in 1937. There were in all 121 cases of Scabies in school children and 80 families were affected. 95 Treatment was carried out at home in the first instance, r^-ed instruction and sufficient ointment being given to the utffei'r to enable her to carry out the necessary applications. In fa vast majority of cases a cure was effected in less than a hi°ht, and it was easy to pick out the mothers who would not j^could not do the treatment efficiently. In those cases it was ^.issary to send the children to the -Kensington Cleansing Station ^treatment, and even then in some cases it was weeks before jare was effected. |
61920aac-e922-4e02-bd32-11cfff4cc451 | The Acarus Scabei, the cause of Scabies, will live for a time Jprt from the human body if conditions are favourable and he /i kept warm. It is therefore perfectly understandable that any teount of treatment at public baths will be ineffective if infected Clothes and articles of clothing are kept in the home. Instructs were given to the parents of infected children to boil their Skets and pillow cases, and their bedding and clothing which cctii not be so treated were removed and disinfected. It only an infected pair of gloves to be overlooked for the treatment rendered null and void,- and in some of the infected persons fw idea of ordinary personal cleanliness was most elementary and homes, according to reports after visits, dirty and untidy in extreme. Unexpected and inexplicable opposition was often «MG0untered also to the idea of having mattresses and clothing in a disinfector, and in every case from those whose failure fa clear up the infection was most apparent. |
b5adb175-4036-466d-8d1e-60b4f59f56d9 | Scabies is not a wfcfiable disease, and so the law gives no power of compulsory ^infection. Sometimes success was attained by threat of report to the "S.P.C.C., but the position is not satisfactory and Scabies conhates to spread in the Borough. Several families became infected more than once during the i families had Scabies three times during the year, and 5 wlies had it twice. It will be evident from the tables below **ving the number of cases and the schools and departments '■^fcted, how widespread was the infection and how persistent "®ugh the whole year. The majority of cases occurred in South pfcn and the schools which serve that area. In the lists of "'"'•lies affected, the same family is sometimes noted under both "^nj'mede and Priory Schools and in some cases also an elder attends the Central School. 96 School. Department. Cases. |
b2e657a3-544c-42af-8ac4-1568f9ec11ec | Families Priory All 30 '20 Berrymede All 25 17 Derwentwater & Central All 15 13 Acton Wells All 15 8 Rothschild All 11 7 Beaumont Park All 10 8 John Perryn Junior & Senior 5 4 Special (M.D.) 4 4 Southfield Infants & Junior 2 2 West Acton 2 2 Roman Catholic - 2 2 121 87 The times of the year during which these schools were infected are shown below. (2 January. Priory, Berrymede, Derwentwater, Central, Rothschiw, mont Park, John Perryn, Special, Roman Catholic. February. Priory, Berrymede, Derwentwater, Acton Wells, Beaumont" Park. March. Priory, Derwentwater, Acton Wells, Rothschild, Park, Southfield, Roman Catholic. April. |
11829778-904f-4b85-872c-ecf052d40498 | Priory, Berrymede, Derwentwater, Beaumont Park, May. John Perryn. June. Priory, Berrymede, Beaumont Park. July. Priory. August. Berrymede, Acton Wells. September. Priory, Berrymede, Derwentwater, Acton Wells, John Perryn, Southfield, West Acton. October. Priory, Berrymede, Derwentwater, Rothschild, West Acton. November. Berrymede, Acton Wells, Beaumont Park, John December. Berrymede, Acton Wells. 97 Parents are always asked when a child is found to be suffering from Scabies, if any member of the family who does not attend school is suffering from a similar complaint. If so, treatment is offered for infants or for adults as the case may be. |
23980536-9f16-4d1e-a22b-5e67e71dee7b | It is also advised that if the infected person has been sleeping in the same bed as any other member of the family who is not infected, that treatment should be given to the apparently clear child also, in case the statement that the child is clear is erroneous and all effort wasted by clearing one and not the others. REPORT OF THE SCHOOL DENTAL SURGEON. There has been an all round rise in the number of school children treated this year. The acceptance rate for elementary Schools was maintained at about 70%, while for the secondary Schools the percentage of acceptances has risen from 66.5 to 72%. Actually, though the amount of treatment carried out for the secondary schools was considerably more, this does not mean that the condition of the mouths was not so good. |
418e9c0c-a37b-4d4f-a45e-f7fff9078fec | The number treated in 1938 was 328, as against 241 in the previous year, the fillings rose from 385 in 1937 to 529 in 1938, while extractions fell from 165 in 1937 to 112 in 1938. Thus it will be seen that as well as a rise in the percentage of acceptances there was 'a rise in the proportion of conservative work over extractions. This result has been made possible by the introduction of extra assistance to the full capacity of our present premises. Almost double the number of expectant and nursing mothers 36 sent from the Welfare and Ante-natal Centres for oral examination, but this did not result in much increase in the number heated. The reason is, I think, that most of the extra ones were rot in need of such urgent treatment, and perhaps naturally, are not inclined to have anything done at such a time. |
c58e446f-ae98-4927-b596-d7a8c97625af | Just before Christmas the most up-to-date apparatus for the administration of gas and oxygen was purchased for the clinic. This is proving a great advantage in giving a better and quieter (???)esthesia and is also very much more economical in the use of gas than the old type. The amount of oxygen used is, of course, small. 98 Below are given the figures for work done for the secondary schools and for the welfare clinics, as these are not included in the returns to the Board of Education at the end of the report. Secondary Schools. Number of children examined — 618 Referred for treatment 459 Treated — — 328 Attendances for treatment 610 Permanent Fillings 529 ,, . Extractions 84 ,, Dressings 51 Temporary Extractions _ . 28 Welfare Cases. Mothers examined 174 Referred for treatment 173 Treated 99 Dentures supplied 27 Permanent Fillings 40 ,, Extractions 793 ,, Dressings 74 Attendances (Mothers and children) . |
9a380363-a4fe-4386-8741-a51ebdff764b | 386 Anaesthetics given (Mothers and children) 264 Children examined _ 82 Referred for treatment 75 Treated 74 Temporary Fillings 12 „ Extractions 233 ,, Dressings 35 P. H. SlatfR REPORT OF THE SCHOOL OCULIST. The work of the Clinic has been carried on interruption during the past 12 months. During the year 337 school children were referred for examination. Of these, 226 were provided with glasses, 7 were treated privately, and 34 refused treatment. 70 children were found not to require glasses,and there were 14 cases of external disease of the eye. 99 22 children and 1 mother were referred from the Welfare Centres. 18 of the children and the 1 mother did not require treatment, 7 were supplied with spectacles and 2 cases refused treatment. There were 3 cases of external eye disease. 28 boys were referred from the County and Technical Schools. |
930ab5fa-f100-4ed6-836c-009e28f94728 | Of this number 23 were provided with spectacles, 1 went to Hospital and 4 did not require treatment. Two cases of defective colour were examined at hospital and proved to be cases of partial red-green blindness. A few cases have been referred to hospital for orthoptic treatment and these are the cases in the Clinic which would benefit from a course of treatment. Children undergoing treatment have to attend two or three times a week and the course of training may extend over many weeks. In quite a number of cases, parents, though willing for their children to have the benefit of a course of training, have stated that they cannot afford either the time involved or the cost of the fares to and from town. There is no doubt that the acquisition of the necessary apparatus and the services of a trained orthoptist for two sessions a week would prove 2 great asset to the Clinic. F. Clifton. PROVISION OF ME.ALS. |
c7594eec-fd4d-4453-8ff8-fa98f321de9a | Free meals and milk continue to be provided at 7 Feeding Centres in Acton. These meals and milk are granted on medical grounds to children certified by the School Medical Officer to be Suffering from malnutrition and to be medically in need of the extra nourishment. When assessing the nutrition of a child, is the case to be considered from the standpoint of the present physical State of the child, or is it to be assessed from the evidences present of faulty nutrition post or pre natally? When considering a child's Qualifications for the granting of free meals and milk it is probably fetter to take the present state of the child, its weight, height, lack of muscular tone, flabby skin lacking that polish (which is ore of childhood's greatest charms), lacklustre eyes and hair, and poor posture indicating fatigue. |
f8f8e9b4-e584-41d4-881a-32e4d65d05ce | The weight for height measure, as a means of assessing nutrition has been abandoned for some time, for it is perfectly possible to have an overweight child who is flabby and whose nutrition leaves much to be desired. . To assess nutrition, from the national point of view, requires a different standard. We come then to consider the 100 ravages made permanently in the human frame before birth, affo birth and at the present time. Lack of proper nutrition of the mother during pregnancy may result in a poorly developed skeletol in the child with teeth liable to early decay. Lack of sufficent protective substances in the diet in infancy will produce deformities in the bony skeleton due to rickets and the want of adequate diet later may cause lack of muscular tone, with resulting bad posture and deformities. It must not be forgotten however, that diet is not the beginning and end of the question of nutrition. Environmental factors must be considered. |
d003c558-3913-469c-9033-4432163e2da8 | Overcrowding with its resulting lack of proper rest, continual noise in home surroundings with its lack of repose, lack of sunlight and fresh air, lack of proper exercise irritability of parents and neighbours because of their being herded together or worried by financial matters,—all these play their part in the production of the final result, the child suffering from na nutrition as we call it for want of a better name. Any child, it might be said, who is not suffering from a disease may be stated to be suffering from malnutrition it its present condition is capable of improvement. There remains much to be done, very much in the way at educating the general spending public on what foods are essential what foods are good, and what foods do not repay in food value the money spent on them. It is unfortunate that, as a naton we are not milk drinkers. It is by no means unusual to find that mothers do not give the children milk, because " they don't like it." |
8ff29761-23b1-46b9-a1e9-e2a24d8d28d6 | That is naturally a sufficient reason to someone who does not understand the value of milk as a food nor how necessary it is to the growing child. It has been held by some that children who do not like milk are sensitive to it, and that it will do harm make them drink it, but the child to whom milk is poisonous very rare indeed. In an experiment carried out in America in over 5,000 children, only 147 were found to be made ill by it a very small percentage. At the end of the report will be found the Tables of figure for provision of free meals and milk during 1938. During the Summer holidays all the children on free meals and milk were reviewed and those children who had attained satisfactory level of nutrition were taken off free meals and given only milk twice daily at school instead. Watch was kept on these children and in only four cases was it necessary to put the children back on free meals again. In every other case the nutrition was 101 (???)intained. |
bf93c41f-b392-4428-bd3a-ef25019eb2cf | This is a slight indication that in the majority of cases children will be given an adequate meal at home and that what is lacking in their diet to improve their condition, is the milk and other protective foods which are present to such a much greater extent in the dietaries of the well-to-do. Advice is given by the School Medical Officer to those in charge of the feeding centres on the need of dishes which should be supplied, brown bread to be substituted for white, fresh fruit for dessert whenever possible, and cheese dishes to be offered. The children clamour for white bread, refuse cheese and cheese dishes, and do not like herrings so we are told, and if that is the case it shows how much needed is education in the home as to which foods are best for children, and which commodities have good food value. Children will eat what they are in the habit of seeing eaten, and resent innovations, and if these articles were seen on the home table more often they would not be refused at the feeding centre. |
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