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51
of tonsilitis. In thirty-three tonsillectomy had been performed at varying periods considerably
before the symptoms of rheumatism were observed (from seventeen of these also adenoids had
been removed); in fifteen others the children were found to have had tonsils removed as part
of treatment for rheumatism.
Teeth.
All children are reported to be under dental supervision, with treatment if required, as
part of the school organisation.
Contacts.
Twenty-five of the notified cases had no contacts.
A history of rheumatic pains was reported in the contacts of eleven cases.
The names of all the other contacts going to school were passed on by the London
County Council district organiser to the Divisional School Medical Officer in order that they
might be observed and examined if necessary.
History of Patients after leaving school.
During 1934 seven children ceased to attend school and are occupied as follows :—
(1) Boy (V. B., æt. 15) is a shop assistant.
(2) Girl (C. B., æt. 14) is a shorthand typist.
(3) Girl (E. M., æt. 14) is a waitress.
(4) Boy (G. M., æt. 14) works irregularly, chiefly as an errand boy
(5) Girl (F. T., æt. 14) in a pipe-making factory.
(6) Boy (S. S., æt. 14) is an office messenger.
(7) Boy (G. B., æt. 15) is a stable yard assistant.
Five children reached the age of 16 during 1934 and still continue their previous
employment.
Holidays for Rheumatic Children.
An annual holiday in the country or by the sea is of benefit to all children;
it is even more necessary for children who are handicapped by rheumatism.
In 1934 the co-operation of the school organisation was secured, and in nearly
every case a holiday was arranged for each child who was physically fit for a holiday
home, special arrangements being made for those attending schools for the
physically defective.
Typhoid and Paratyphoid Fever.
Enteric Fever.
Three cases were notified. In the first, bacteriological examination was
positive for Paratyphoid B. The patient was an infant, aged 3 months. The
source of infection was not traced although information was furnished that the
child had been "playing with drain and dirty water."
The second case was a nurse at a voluntary hospital. Bacteriological
examination gave a Widal reaction positive to B. Typhosus; and a diagnosis of
enteric fever was thus confirmed. The illness began on the 23rd July, the patient
having arrived from Northern Ireland on the 1st July.
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