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81
During the year 1935-36, 48 sessions have been held at the Princess Louise hospital.
Average attendance per session of Kensington patients 19.7
„ „ „ „ other „ 5.6
25.3
The total number of attendances of patients was :—
Kensington Notified cases (a) New 22
(6) Old 326
Unnotified cases (a) New 51
(b) Old 545
Hammersmith (a) New 8
(b) Old 120
Paddington (a) New 4
(b) Old 34
Acton (a) New 14
(b) Old 54
Other boroughs (a) New 4
(b) Old 30
1,212
The new Kensington cases were recommended to attend the clinic from the following sources :—
Invalid Children's Aid Association 5
School medical officers . 23
Princess Louise hospital 16
Private doctors 5
Home visiting after notification 5
Parents 15
Infant welfare centres 3
Tuberculosis dispensary 1
73
The disposal of cases which attended the centre and which needed special treatment may be summarised
as follows :—
Tonsillectomy at Princess Louise hospital 10
Admission to Princess Louise hospital 9
Admission to St. Charles hospital 1
Special schools 5
Convalescent homes 19
Referred to massage department for special chest expansion exercises 2
46
Record of the progress of 104 cases which have attended the centre during
a period of five years or more.
From the records we have been able to collect 104 cases which have been supervised under the scheme for
a period of five years or more. The records of these 104 cases are, for the purpose of this investigation, continuous
and complete ; they are unselected. A few cases which have been seen over a period of five years have not been
included, as the recorded information was incomplete for various reasons. The number may be considered
small in relation to the total dealt with by the scheme, but over a period of five years, children fail to continue
to attend the clinic for a variety of reasons : they may remove from the district; parents may refuse to avail
themselves of the scheme, especially when the child is not obviously ill; they reach the age of 14 and go to work
or reach the age of 16 and become beyond the age limit of the scheme.
The cases are divided into three groups :—
(1) In this group there are children sent to the clinic who may have pains suggesting rheumatism but who
have not had a definite rise of temperature, acute arthritis, cardiac involvement, or chorea. That is to say
they have not manifested a syndrome sufficient to justify classification under the notification regulations.
Twenty-six cases are in this category.
(a) Fourteen cases.—These cases were brought to the clinic on account of pains simulating rheumatism.
They never developed any sign or symptom suggesting cardiac involvement.
(b) Twelve cases.—These cases, in addition to their initial symptoms, manifested at times cardiac murmurs
or extra systoles, but in no case during the period of observation was there any evidence of damage to the heart.
(2) In this group there are seven cases in which the initial symptoms, which were not sufficiently definite
to be notifiable when first seen, developed to such an extent that they became notifiable. Two developed acute
rheumatic fever with a cardiac lesion, and in five it was decided during the period of observation, although they
had had no acute attack, that there was definite evidence of rheumatic carditis.
(3) In this group all the cases were notifiable when first seen ; there are 71 cases.