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149
The Education Authority took no action at that time ; but
in January, 1938, the question was again considered and the
Education Authority agreed to the establishment of a Heart
Clinic subject to the approval of the Board of Education.
In May, 1938, the Board approved in principle the Authority's
proposal to establish a Heart Clinic; and the Education Authority
appointed Dr. Alfred Claude Mitchell Elman,'M.D., M.B., B.S.,
M.R.C.P., M.R.C.S., L.R.C.P., to attend once monthly.
The first session was held at Leyton Green Clinic on 25th
June, 1938. During the six months ended 31st December, 33
children made 66 attendances. Dr. Elman submits the following
observations.
Report by Physician in Charge of Heart Clinic (Dr. A. C.
Elman).
The Leyton Heart Clinic was opened on 25th June, 1938,
and cases are seen monthly. From the date of inception until
31st December, 1938, I have examined 33 new cases of whom 17
were boys and 16 girls. In all, 66 attendances have been made,
this figure including new cases and " re-inspections."

It can be seen that the largest number of cases are classified
as having Mitral Regurgitation. It has been my experience that
such cases may gradually develop the more serious lesion Mitral
Stenosis, and observation of these cases over a long period is
essential.
The cases described as "Doubtful" include children suffering
from tachycardia, extra systoles, slight changes in the heart sounds,
etc.—most of which I expect to become normal in the course
of time.