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82
It may be noted that a normal heart never shows an increase of more than
40 beats and usually returns to normal rate after 120 seconds. These figures of
course must be taken in conjunction with other signs and symptoms.
By the courtesy of Mr. McKay, the Secretary of the Hospital of Sick Children,
Great Ormond Street, the following report has been furnished by Dr. W. H. P.
Sheldon, who is in charge of the Rheumatic Clinic, and Miss Salmon, the Hospital
Almoner.
Great
Ormondstreet—Dr.
Sheldon's
report.
"Numbers.—Since its inception on January 1st, 1928, the Clinic has entered
on its register 507 children, of whom 260 reside within the L.C.C. boundary and 247
reside in extra metropolitan districts. Cases discharged from the Clinic, (over-age,
died, etc.) 37.
"Procedure.—The Clinic is run in conjunction with the out-patient department
and meets each morning in the week, thereby differing from other Rheumatic Clinics
which have only one or two sessions per week.
"For the first half of the year, Miss Allen, a voluntary worker, was entirely
responsible for the organisation of the attendances of the children. The L.C.C.
marked their official recognition of the Clinic on July 2nd, 1928, by supplying a
half-time social worker, Miss Sydenham, to assist in the management of the L.C.C.
school children. The efficient assistance of this worker has been much appreciated.
The maintenance of regular attendance of the children is carried out by Miss Allen
and Miss Sydenham. All recommendations for half time schooling, attendance
at Schools for Physically Defective Children, extra nourishment and correspondence
with the School Medical Service are transmitted by Miss Sydenham for L.C.C.
children, and by the Almoner's Department for the extra-metropolitan children.
"It is interesting to note that as a result of the Clinic being recognised by the
L.C.C., all L.C.C. children attending the Clinic have special facilities for cheap
tramway tickets, and if they are on a School Register, their attendance at Hospital
is counted as attendance at school.
"The Almoners interview all patients on their first attendance and obtain all
necessary particulars, and in the event of convalescence being recommended, they
make all arrangements. The medical notes together with a report of the home
conditions are made on a special form, (attached) and kept in a private file.
"The Clinic embraces all types of rheumatism; potential rheumatics, early
heart disease, established cardiac cripples, and cases of chorea. It has not been
considered advisable to divide the children into various groups according to their
particular manifestations of rheumatism, as is done at some clinics, notably Glasgow.
Each case, both from a medical and social point of view, is considered on its own
merits.
"Home Visits.—During the year, 305 home visit reports have been furnished.
Of these 124 have been made by School Care Committee Workers in London, whilst
on the extra-metropolitan homes, Miss Allen has made 181 reports. Owing to the
exceptionally high standard of the latter's work, it is hoped that in the near future
she may be able to visit the homes of all the children in the Clinic. Of the 305
homes visited, 111 were reported damp, and 81 as ill-lighted.
"Co-operation with the School Medical Service.—An increasing number of
children is being referred for supervision to the Clinic by the School Medical Service,
whilst reports to the School Medical Service have been sent on L.C.C. and extrametropolitan
children.
The following figures re reports sent from this Clinic apply only to L.C.C.
children:—
A. on initial attendance 260
B. on special cases 43
In addition 8 children have been sent to Physically Defective Schools.