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80
Particulars of cases of acute rheumatism in children coming to our knowledge
are recorded in a register under the following headings:—
Name, &c.
Surname
Christian name
Sex
Date of birth
Address
School
Source of information
Classification and Symptoms
Rheumatic tendency
Sub-acute rheumatism
Acute rheumatism
Post-rheumatic
Arthritis accompanied by
rise of temperature
Rheumatic chorea
Rheumatic carditis
Tonsils, Adenoids and
Teeth.
Condition of tonsils
Presence of adenoids
Teeth including oral
sepsis
Treatment.
Private doctor — date of
first attendance
Out-patient at hospital—
name of hospital and
date of first attendance
In-patient at hospital—
name of hospital and
date of first attendance
Convalescent home—name
of home and date of admission
Home Conditions.
Position of rooms in
house
Evidence of Dampness
Lighting
Ventilation
Overcrowding
Sleeping Conditions.
Separate room
Separate bed in room
Room shared with—
Adults (number)
Children (number)
Bed shared with—
Adults (number)
Children (number)
Hours of Sleep.
Time of getting into bed
Time of rising
Help wanted for patient
Clothing
Boots
Stockings
Dispensary letter
In-patient treatment
Convalescent home
Name of organisation
referred to
Clothing.
Condition of clothing and
boots
History of Rheumatic
Fever.
Rheumatic heart disease
in family—
Father
Mother
Brother
Sister
Other members of
family
Food.
Quantity
Suitability
Contacts.
Name
Sex
Age
Any sore throat
Any pains in muscles,
joints
Any shortness of breath
Any fidgetiness or extreme
nervousness
The intention is that no rheumatic child requiring help in any way shall go
without it.
The Sanitary Inspection of the homes is made by experienced Sanitary
Inspectors; we are requiring for these children as high a standard of
environmental hygiene as can reasonably be achieved,