View report page

89
" The facilities at these country hospitals for treatment of the acute phase of
the illness and for education under ideal conditions during the necessarily long
convalescent stages put this form of treatment on a high standard and secure excellent
results. The pressure on the voluntary hospitals is so great that rheumatic
children can only be detained till defervescence of the acute stage and although
every means is usually adopted to secure convalescence elsewhere under the best
available conditions, this is not quite so satisfactory as treating the illness throughout
in the same hospital and under such conditions as obtain at these country institutions.
The acceptance of children for institutional treatment is dependent on the decision
of a medical referee. In this connection, 46 children were examined in voluntary
hospitals and 292 were visited in their own homes or otherwise specially seen. The
help of the Invalid Children's Aid Association has been much appreciated; they
dealt with or reported on 301 children and arranged treatment for those children
whom it would have been otherwise impossible to place. Recognition must also
be given to the deep interest and able work of the care committees who have specially
reported on the social and environmental conditions of 280 children admitted for
treatment. On the result of these reports, 37 cases of dampness in the houses
were referred to the local sanitary authorities and 16 cases were put forward for
consideration of the housing branch of the valuer's department. The children's
cf^e organisation also furnished 322 special reports on a variety of matters bearing
on the welfare of rheumatic children.
"The 544 children nominated for residential treatment were dealt with as
under, classified in sexes, the girls being shown in brackets :—
" High Wood Hospital.—Admitted in 1929, 71 (150); discharged in 1929, 51
(120); still under treatment, 29 (61); died in hospital, 0 (2).
" Carshalton.—Admitted from all sources to rheumatism unit, 29 (39) ; discharged,
23 (29); still under treatment, 19 (27) ; died in hospital, 2 (0); Carshalton,
subacute beds—admitted, 7 (31); discharged, 0 (22); still under treatment, 7 (21).
" Treatment arranged by Invalid Children's Aid Association, 21 (25); cases
considered unsuitable and no longer requiring treatment, 23 (37) ; parents averse
from residential treatment, 8 (17); admitted to hospitals or infirmaries, 9 (15);
convalescence arranged by hospitals or privately, 20 (24); died, 1 (0); number
nominated in 1929 still awaiting consideration, 30 (44).
" The type of school and the modifications of school curriculum best suited to the
child are decided after examination at the County Hall on return from hospital.
The child's future welfare is largely dependent on the betterment of the home
conditions and on the parents' adoption of the doctor's advice in their management
of the child. This can best be secured by the sympathetic help given during the
home visits of care workers, who furnished following-up reports on 317 children who
had returned from hospital. Every endeavour is made to keep these children under
medical observation and the progress reports obtained from High Wood and
Carshalton are sent on to the doctor or hospital who originally treated the child.
Information along specified lines is also obtained from the school doctors at regular
intervals. During the year, 355 continuation reports were obtained.
" This work is well worth while, for with the exception of a few congenitally
weakly ones, the children on their return are in excellent condition. Weight is increased,
pallor has given way to the rosy colour of good health, lassitude and fatigue
to brightness and spontaneity, and debility to robustness. In many cases the heart,
apparently affected on admission, has on return shown no abnormality, and in the
majority of those children whose hearts were definitely affected, quiescence appears
to have been established, for relapses are definitely less in them than in others not
so treated
" Arrangements for the attendance of children at the supervisory centres directly
co-operating in the scheme are made by the care organisers who attend at each