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76
Cases Attending the Centre 1927-1929,
Kensington 296
Hammersmith 65
Hounslow 3
Fulham 3
Putney 2
Paddington 1
370
Of these cases, forty have been discharged because they were not found to be suffering
from rheumatism, six have moved out of the locality, four have passed beyond our age limit,
and three have died.
During the year 1928-1929, forty-nine sessions have been held at the Princess Louise
Hospital and the average attendances have been as follows :—
Kensington 12.6
Other Boroughs 3.6
16.2
An attempt is made to equalise the numbers attending on any given day by giving appointments
for each case. This is done by sending a post-card requesting attendance on a particular
date ; if the child sent for fails to attend the parents are visited by voluntary workers of the
Invalid Children's Aid Association. In spite of these endeavours the numbers attending are
subject to very considerable fluctuations and the seasonal prevalence of rheumatic exacerbations
during the winter months appears to be the main determining factor.
Sources of Material.
The new cases attending the Centre are referred by a number of different persons and
institutions. From the Boroughs other than Kensington, the Invalid Children's Aid Association,
the school medical service and the Medical Officers of Health send the larger portion. The
sources of the Kensington cases can be seen by referring to the following table :—

The Notified and Unnotified Cases Attending the Rheumatism Supervisory Centre.
The Kensington (Acute Rheumatism) Regulations, 1927, define the notifiable condition
as (a) rheumatic pains and arthritis, if accompanied by a rise of temperature ; (b) rheumatic
chorea; (c) rheumatic carditis, occurring separately or together, in a child under sixteen
years. In practice, it is found that a large number of cases requiring supervision are not
compulsorily notifiable, e.g., cases recovered from chorea; cases of subacute rheumatism in
whom the doctor has not had the opportunity of taking the temperature during an acute
stage ; and cases of rheumatic heart affection no longer in the stage of carditis, but suffering
from valvular disease, adherent pericardium, etc.
Kensington Cases in attendance at the Rheumatism Supervisory Centre 1927-1929.
Notified* 96
Unnotified 200
296
*It should be explained that cases presenting themselves at the Centre are notified by the Medical Officers
if they happen to be notifiable but not previously notified.