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22
ACUTE RHEUMATISM.
This widely prevalent disease was made notifiable as from the 1st March, 1927, by virtue
of the Paddington (Acute Rheumatism) Regulations, 1927. Paddington was the first area
in Great Britain to make acute rheumatism notifiable.
The above Regulations remained in force for a year and were extended to March 31st,
1930, from which date the disease, under further Regulations, became permanently notifiable
in the Borough.
During 1932, 21 cases of acute rheumatism were notified. This figure compares with 37
cases in 1931, 43 cases in 1930, 52 cases in 1929, 76 cases in 1928, and 34 cases for the ten
months of the year 1927 during which the disease was notifiable.
Acute rheumatism is defined in the Regulations as being the following conditions,
occurring separately or together in a child under the age of 16 years: —
(1) Rheumatic pains or arthritis, if accompanied by a rise of temperature;
(2) Rheumatic chorea;
(3) Rheumatic carditis.
The Regulations enjoin the medical officer of health to make such enquiries and take
such steps as are necessary or desirable for investigating the source of disease, for removing
conditions harmful to the patient and arranging for the treatment of the patient.
All these enquiries and any necessary action have been delegated to the "Rheumatism
Supervisory Centre" which was opened at Paddington Green Children's Hospital on October
9th, 1926. During the year 1932, a grant of £150 was made by the Council towards the
cost of the maintenance of the centre.
The objects of this voluntary centre are:—
(1) To meet the need shown by rheumatic cases for careful supervision during periods
of apparent quiescence to prevent the development of heart disease.
(2) To supervise rheumatic children when apparently well by periodical examinations,
and to instruct the parents to consult their usual doctor or hospital should fresh
symptoms of rheumatism develop. Treatment at the Centre itself is only given
in urgent cases.
(3) To instruct parents in the care of rheumatic children and to make investigations
in Paddington into the causation of rheumatism.
The Centre is under the personal supervision of one of the Honorary Physicians to the
Hospital and there is also a salaried medical officer who devotes her whole time to visiting
cases of the disease and making such enquiries as may elucidate the causes thereof.
The work of the Centre lies with children who are suffering from rheumatism in any of
its forms, whether slight or "acute" as defined in the Regulations.
Paddington Green Children's Hospital Rheumatism Supervisory Centre.
Report for the Year 1932, by Reginald Miller, m.d., f.r.c.p., Physician-in-Charge.
In my report for last year the objects and methods of the Rheumatism Supervisory
Centre were fully explained. It is therefore sufficient to state that it endeavours, by
preventive treatment and attention to the details of housing: and schooling, to ward off serious
attacks of rheumatism in children, and thus to prevent valvular disease of the heart which
will, if established, ultimately prove fatal. The work of the Centre, therefore, consists more
in watching over children threatened by these dangers than in treating them in the acute
phases of the disease: nevertheless facilities for the treatment of rheumatism in children in
any and every phase of the disease are provided under the scheme.
Sessions and Attendances.—The Centre was open on 43 Saturday mornings during1 the
year. One hundred and fifty-nine children from the Paddington Borough attended, and
the total number of attendances was 298.
Number. Attendances.
New cases 33 58
Old cases101 213
Discharged 25 27
159 298