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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 1933. by Reginald Miller, M.D., F.R.C.P.,. Physician-in-Charge .
The aims and methods of this Centre have been explained in previous reports, and before giving
the details of the last year's work it may be of interest to express an opinion of the value of the work
as a whole. The Centre was opened in l926, and as I have been in charge from the inception there
has been time to form some definite impressions of the value of the work done.
On the encouraging side several points may be mentioned. First, this Centre was the earliest
to be started in London, and since that date over a dozen other Centres run on the same lines have been
inaugurated; this shows that the medical profession regard the work as certainly worth while.
Secondly the number of serious relapses and fatalities appears to be growing less, probably owing to the
fact that we are now getting our cases earlier and before they are badly affected with heart disease.
Thirdly, it is noticeable now that when, a really severe case of rheumatic heart disease comes under
observation, of the type known as "cardiac cripple," it is almost invariably a child who has not
come under any efficient scheme of supervision. Lastly, it is encouraging that the Centre appeals
so. much to the mothers of the patients that the number of cases lapsing is always very low; during
1933 there were none.
On the other hand it must be recalled that both of the last two years have been, exceptionally
mild as regards rheumatic infection in children; it is not yet likely that) this milder form of the
malady will become permanent.
The Centre's work would be still more useful if more notified cases attended, and if more acute
cases for in-patient treatment were referred to> it. Every effort would be made to accommodate such
cases, and.' it need' not be said that the Hospital has every possible facility for treating the worst cases.
Sessions and Attendances.—Owing to rebuilding in July, the number of sessions was reduced to
39 during, the year 1933. The following, numbers refer to Paddington children only:—
Number. Attendances.
New cases 22 38
Old cases 139 236
Discharged 17 27
178 301
Notifications.—The number of notifications during 1933 amounted to 37. As has already been
mentioned the number of cases coming to the Centre by this means is too small. We have therefore
traced what has happened to the 16 cases notified during the first six months of 1933, with the following
result:—
Attending own doctor 6
Attending other hospitals 3
Attending tuberculosis dispensary 2
Attending Centre 2
Over age 3
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Though probably some of these cases will ultimately come on to the Centre when convalescent,
the above figures cannot be regarded as satisfactory.
New Cases.—Of the 22 new cases, 5 were referred through the Public Health service, 15 through
the School Medical service, and 2 through hospitals. It will be seen that the private practitioners
who notify cases of rheumatism are not transferring their patients when convalescent to the care of
the Centre for supervision as a rule.