View report page

It is the considered opinion of the health visitors and officers of the Invalid Children's Aid Association, etc.,
that there are still cases of rheumatism which have escaped medical supervision in any form, in spite of the activities
of the various bodies which are able and anxious to report their cases.
Hospital Accommodation.
St. Mary Abbots Hospital (Kensington Infirmary) have reserved 12 beds for rheumatic cases. The girls
are accommodated, if possible, in a ward by themselves, which is advantageous, as it is essential to their proper
treatment that these cases should be kept very quiet, and it is difficult for the nursing staff to give the children
the necessary attention to attain this ideal in a large ward containing adults and children.
Two beds are reserved at the Princess Louise Kensington Hospital for children, but when the pressure on
the beds permits more than two cases may be admitted.
Convalescent Treatment.
Very prolonged treatment is necessary in severe rheumatism cases, the essential factor being complete
rest in healthy surroundings. In chorea also, and in mild cases, where there has been even slight cardiac involvement,
it is imperative that the treatment should be extended over many months.
It has been definitely established that the danger of recurrences has been reduced by these means. Also
where there has been cardiac involvement there is a certainty that the severity of the permanent damage to the
heart is thereby lessened, or this serious disability may even be avoided altogether.
It is only in rare cases that home conditions make such prolonged domiciliary treatment possible. It is
also much less depressing for a child to submit to this curtailment of his activities when surrounded by others
undergoing the same restraint.
It is therefore satisfactory that the accommodation at convalescent hospitals and specially organised
convalescent homes has increased, although it is still inadequate, and there are still long delays before admission
to these institutions can be arranged.
During the year 1929-30, 28 children were sent away by the Invalid Children's Aid Association, working
through the Centre for a period of a few weeks. The after treatment for the acute and sub-acute cases which
had been admitted to St. Mary Abbots Hospital or the Princess Louise Hospital, was arranged by the institutions
concerned, in conjunction with the Invalid Children's Aid Association. Under the London County Council
Rheumatic Scheme many were sent to Queen Mary's Hospital, Carshalton, and to Highwood, Brentwood.
The Ladies' Association of the Princess Louise Kensington Hospital for Children pay for:—
2 Beds at West Wickham Heart Home.
1 Bed at Children's Heart Home, Lancing.
These beds are reserved for the benefit of children who have been in-patients of the above hospital.
The work of the Centre in regard to the disposal of severe cases, and the arrangements made for operative
treatment, convalescence, etc., during 1929-30 may be summarised as follows:—
Tonsillectomy at Princess Louise Hospital 33
Admission to St. Mary Abbots Hospital 20
Admission to Princess Louise Hospital 9
(Special) Physically Defective School 10
Convalescence (average length of stay 11 weeks) 28
CLINICAL REPORT.
It is not possible to write a very full clinical report on the work of the centre this year as the writer of this
part of the report has been in charge for a few months only.
It is clear from the examination of children at the supervisory clinic that there is great difficulty in the
diagnosis of the earliest signs of juvenile rheumatism. It is unjustifiable and will not further our investigations
to label as rheumatic any child who complains of pains just because no other cause for the pains can be found.
Rheumatic pains are described as occurring chiefly in the limbs, arms as well as legs, and particularly in the
thighs, also at the back of the neck. They occur during the night as well as on exertion, and are, on the whole,
more severe than pains due to other causes. In spite of this differentiation however, the picture is, very often,
far from clear. There is at present no test, such as the Wasserman test for syphilis, which is specific for this disease.