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To these figures must be added as an integral part of the work of the Centre the admissions
to the wards of the Paddington Green Children's Hospital, and the number of operations for
the removal of diseased tonsils. These are referred to later.
Notifications.—-The number of new cases notified to the Medical Officer of Health during
the year was 21. The notification of cases takes place during the acute stages of rheumatic
infection only, and every effort is made by the Borough Health Visitors to get the children
to attend the Centre when the acute symptoms have passed off. As there is necessarily an
interval of some weeks or even months between the date of notification and the time when the
cases become suitable for the Centre, it is difficult to ensure the ultimate attendance of all
the notified cases.
The small number of notified cases suggests that the incidence of juvenile rheumatism
throughout the Borough has been abnormally small, owing to the mildness of last winter and
the autumn of the past year.
New Cases.—The number of new cases attending the Centre during the year was 33.
These were referred to the Centre in the following ways:—
Through Public Health Service 6
,, School Medical Service 20
,, the Hospital 4
,, other means 3
Classification of New Cases.—-The classification of the new cases at their first visit was
as follows:—
Rheumatism. Heart disease.
Early 13 0
Active 2 2
Quiescent 15 suspected 8
definite 5
Absent 3 0
A certain number of cases, both new and old, developed symptoms of active disease
during the year.
Social Standard.—Of the 33 new cases, the circumstances of the parents were classified
as comfortable in 21, poor in 3 and very poor in 3. In 4 instances the houses were reported
to the Medical Officer of Health as damp, and this was remedied.
Treatment.—The following table summarises the work done amongst the 159 children
attending the Centre during the year:—
Referred for treatment for active rheumatism:
as in-patient, Paddington Green Children's Hospital 4
as out-patient ,, „ „ ,, 36
Elsewhere 2
Removal of diseased tonsils :
as in-patient, Paddington Green Children's Hospital 7
as out-patient ,, „ „ ,, 9
Elsewhere 1
Home conditions referred to Sanitary Authorities 4
Recommendations:
to Physically-Defective School 3
for prolonged period in country 2
Discharged:
over age 13
non-rheumatic 3
moved away 5
non-attendance 4
General Review of 1932.—Owing to the mildness of the winter 1931-32 and of the
autumn of 1932, the amount of rheumatism amongst the children has been much below the
average. But it seems clear that, after making allowance for this fact, the fullest use is not
yet being made of the Centre. The cases combed out of the schools seem unduly small in
number, and the number of notified cases which fail to make their appearance at the Centre
after the acute symptoms have subsided seems unduly large.