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21
ANTHRAX.
No case of this disease was notified during the year.
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 1934, 41 cases of acute rheumatism were notified. This figure compares with 37 cases
in 1933, 21 cases in 1932, 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 1933, a grant of £100 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 1934 by Reginald Miller, M.D., F.R.C.P., Physician-in-Charge.
In 1934, for the third year in succession, the rheumatism amongst children has been unusually
mild. Such a sequence is very exceptional, and it will be of interest to see how the patients under
the care of the Centre react in the event of a serious epidemic of the disease when that next appears.
Probably the mildness of the disease in the year under review accounts for the small drop in the figures
of the attendances at the Centre, but there is still evidence that full use is not yet made of the facilities
offered.