Library Collections: Document: Full Text

-2- Henry C. Wright. Survey of Cripples in New York City, 1920.

Eighteen orthopedic hospitals reported in the International Society Survey of 1924. Nine of them replied with estimated percentages. These were applied to their total capacities, with the following results:

Nine other hospitals reported quantities in a group of 5,171 children, as follows:

Fifteen convalescent homes reported the following percentage findings on an average total capacity group of 923 children:

For the entire group of 6,507 children representing thirty-three institutions in seventeen states, the following percentages were tabulated:

One other source of information is presented in the form of an Ohio Department of Health Report on 1,125 clinical orthopedic diagnoses. The most frequent orthopedic diseases presented are the following:

The primary conclusion to be drawn from these figures is that infantile paralysis now probably causes the crippled condition of more children than does any other disease. The only group which fails to demonstrate this fact is that of the convalescent institutions, probably because the reduction of surgical interference in bone and joint tuberculosis has filled these institutions with this class of patients requiring heliotherapy treatment and general convalescent care. Although it may be safe to approximate the proportion of poliomyelitis at about one-third, the exact group division depends on the location, on the specific interest of the attending orthopedists, and on the time of investigation. Infantile paralysis is an epidemic disease, and new groups of after-care patients appear periodically.

It is probably safe to conclude that "surgical" (bone and joint) tuberculosis is second in frequency among these diseases.

Somewhat lower than infantile paralysis, the percentage of this cause is probably considerably higher than is indicated in the several reports here presented. There is always a large number of crippled tuberculous patients under care in the general and special sanatoria of the country. In thirty-one general sanatoria reporting in the International Survey, approximately 6.5 % of the entire group of adult and juvenile beds represented were then devoted to children crippled by "surgical" forms of tuberculosis.-1- There are approximately 150 special tuberculosis institutions in this country which admit this type of patient. Furthermore, with the exception of one or two small infantile paralysis homes, the sanatorium is the only special institution exclusively devoted to a specified crippling disease. A number of such institutions are reserved for crippled children. Outstanding examples are the Seaside, a state institution at Niantic, Connecticut; the North American Sanitarium at Ventnor, New Jersey; and the Neponsit Beach Hospital, at Rockaway Beach, New York.

-1- 304 in a group of 3,139 general sanatorium beds.

Judging from the entire group of statistics, congenital deformities would seem to be third in frequency, slightly over one-tenth; rachitic deformities fourth; and trauma fifth. The high percentage of rickets in New York City may be ascribed to the fact that this condition results from malnutrition, a common metropolitan phenomenon. Accepting this classification of causes, only peculiar local conditions can explain the variation in the Ohio report. It will probably be impossible ever to arrive at a permanent and specific tabulated classification of the frequency of various causative diseases among crippled children. The value of such a table would hardly justify the effort involved in acquiring the necessary statistics. But, as the needs involved in curing and preventing the several conditions vary according to the nature of the diseases, it is significant to know approximately in what order of frequency they may be found.