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79
Help wanted for patient. History of Rheumatic Contacts.
Fever.
Clothing Rheumatic heart disease Name
Boots in family— Sex
Stockings Father Age
Dispensary letter Mother Any sore throat
In patient treatment Brother Any pains in muscles,
Convalescent home Sister joints
Name of organisation Other members of Any shortness of breath
referred to family Any fidgetiness or extreme
nervousness
On the occasion of the visit of Miss Bell the register is brought up to date
as well as at intervening times. 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.
Rheumatism Supervisory Clinic.
A Rheumatism Supervisory Clinic is held every weekday at the Hospital for
Sick Children, Great Ormond Street, beginning at 9 a.m.; it is available for children
up to 12 years of age. After this age they are automatically transferred to
St. Bartholomew's or King's College Hospital, or to the hospital they have attended
before they came to Great Ormond Street Hospital.
The Physician in charge of the Clinic, Dr. Wilfred Sheldon, who is also Junior
Physician in charge of the Children's Department at King's College Hospital,
Camberwell, sees children who attend the medical out-patient department in the
same room as two other Physicians who refer children to him; he is also able at the
same time to consult conveniently with his two colleagues.
The presence of rheumatism is by no means always easy to determine: in the
early stages when obviously a diagnosis is of the greatest value, this can often only
be done by watching the child over a period of three to six months, during which
time the child attends regularly at the Clinic. A point of interest is the possibility of
malingering taking place in the case of elder girls whose services are valuable to the
mothers at home for domestic purposes; such girls they say have rheumatic pains
and are kept from school, just as the younger ones say they have ear-ache.
At the Clinic comprehensive records are kept as to the children's physical
condition. Advice is given on such matters as clothing, exercise, diet, and any
alteration desirable to the child's curriculum at school.
At the Great Ormond Street Hospital Clinic all stages of rheumatism are
treated, not only the early stages.