Clinical and pathological report on the pneumonia of children as it prevails among the poor in London / by Charles West.

  • Charles West
Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: Clinical and pathological report on the pneumonia of children as it prevails among the poor in London / by Charles West. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    REPORT ON THE PNEUMONIA OF CHILDREN AS IT PREVAILS AMONG THE POOR IN LONDON, If any person were to estimate the importance of pneumonia in early life from the space allotted to it in English works on the diseases of children, he would doubtless conclude that a malady concerning which the most experienced have thought it necessary to say so little can neither be grave in its character nor fre- quent in its occurrence. Our tables of mortality, however, show that pneumonia is the cause of a larger number of deaths in childhood than any other diseases, with the exception of the exanthemata. It appears from the Appendix to the Third Report of the Registrar-General, that during the year ending May 22, 1841, 22,429 persons died within the Metropolitan districts under the age of fifteen. Of these 3058, or 13‘6 per cent, died of pneumonia; 2963, or 13 0 per cent, of convulsions; and 1216 or 5'4 per cent, of hydrocephalus. Avery similar result is obtained by examining the returns from Manchester, Liver- pool and Birmingham, which are contained in the same report. In tlie year 1839, 11,164 deaths took place in these three towns, of persons under the age of fifteen. Of these persons 1348 or 12 per cent, died of pneumonia, 1615 or 14’4per cent, of convulsions, and 493 or 4*4 per cent, of hydrocephalus. The slight excess in tliis case of deaths from convulsions cannot be regarded as in- validating the statement made as to the extreme frequency of pneumonia; but depends doubtless on the diflSculty of obtaining an accurate return of the causes of death in places where there is a large proportion of migratory popula- tion, such as the Irish in Liverpool. That this is the true explanation of the ap- parent excess of deaths from convulsions appears further on observing that in Birmingham where no such disturbing cause exists, and where the registers may therefore be presumed to be kept with greater accuracy, the per centage of deaths under fifteen years of age from convulsions is only 7 0, and from hydrocephalus 4-0, but from pneumonia 16'0 per cent. Even though the above returns were not completely exact, they yet must be regarded as affording a close approxima- tion to the truth, and as establishing the serious nature as well as the frequent oc- currence of inflammation of the lungs in childhood. A very large number of cases of this disease came under my notice at the Finsbury Dispensary, in the years 1841 and 1842, and at the Children’s Infirmary in 1839-42,and the results ofvvhat I believe that I then learned are embodied in the following observations. For the opportunity of investigating both this and many other diseases of infancy during many years previous to my appointment to the office of physician to the Children’s Infirmary, I am indebtecl to the great kindness of my friend and predecessor Dr. Willis ; and gladly acknowledge tlie extent of an obligation which I can never hope to repay. It will probably occur to some on reading the following remarks, that a great discrepancy exists between many of the statements and opinions they contain, and those of French writers of deserved reputation. To account for this, however, it vyill not be necessary to impugn the accuracy of the observations of either party ; since two causes may be assigned fully adequate for its explanation. These are the very tender age of many of the infants who came under the notice of our continental neighbours; and the extremely unfavorable hygienic conditions in which all children are placed, whether at the Hospice des Enfans Trouv(s, or at the Hopital des Enfans Malades. The investigations of Billard and Valleix were carried on at the Foundling Hospital, and consequently for the most part on children only a few days old ; while no child labouring under pneumonia who came under my notice was less than a month old. It should too be borne in mind that the morbid condition of the lungs of new-born children, which depends on their
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