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35
Since the beginning of the rheumatism scheme at the end of 1926, 2,426 children
have been nominated for hospital treatment and 1,008 children have received treatment
at Queen Mary's Hospital, Carshalton, or at High Wood Hospital, Brentwood.
This part of the work has required 255 visits to hospitals where the children were
in-patients when referred to the Council, and 845 home visits for the purpose of
ascertaining whether these cases were suitable for treatment under the scheme. With
the admission of the children into hospital under the Council's scheme came the
necessity for obtaining information concerning the home conditions in which they
were living previous to the onset of rheumatism. This has called for 1,082 home
visits by the representatives of the school care committees, and in looking through
the files for the past four years one cannot but be impressed by the admirable way
in which the reports on their visits have been rendered. Based on these reports,
147 communications have been made to the medical officers of health of the boroughs
concerned drawing attention to unsatisfactory home conditions and in 66 cases
support has been given to the application of the parents for special consideration
under the Council's housing scheme ; 591 children have been examined at County
Hall on their discharge from Queen Mary's Hospital or from High Wood Hospital
and recommendations made as to the type of school for which they were suited and
how far they could follow the full curriculum of the school. With the return of the
children to their homes the assistance of the school care committees was once more
necessary and 1,078 home visits were made and reports sent in, detailing the
surroundings to which the children had returned, and whether they were receiving
adequate medical supervision on returning to home life. The work in this respect
has taken a step forward this year in that the school care committees are now
supervising rheumatic children after they have left school.
Review of
scheme since
its commencement.
The medical supervision of the children on their return to school has been
undertaken by the assistant medical officers at the schools themselves or by the
specialist medical officers at rheumatism supervisory centres ; 355 of the children
were referred back to the voluntary hospital which recommended them, but these
cases are still supervised in school. The assistant medical officers furnished 1,272
reports on the physical condition of the children, recommending transference to
another type of school should this be necessary, and stating if attendance at a
supervisory centre or the out-patient department of a voluntary hospital is needed,
or whether further treatment in hospital is more suited to their case. In reviewing
the history of the scheme it is apparent that an increased number each year of the
children is being sent for supervision at the rheumatism supervisory centres, rather
than reliance being placed solely upon their being followed up in the schools. With
the increase in the number of these centres it may be found possible to arrange for
the majority of the children who have had hospital treatment under the scheme to
attend at the centres for expert supervision.
The Invalid Children's Aid Association has worked side by side with the rheumatism
section in providing hospital accommodation for children needing this form of
treatment. During the period under review the names of 1,214 children have been
referred to the Association and 1,215 reports have been supplied stating whether
treatment has been arranged for the children, or whether further treatment should
be given under the scheme, and furnishing other valuable information concerning
the family and the home circumstances.
An analysis of 1,028 attacks of all forms of rheumatism shows that these attacks
were more evenly distributed throughout the year than has been shown in other
investigations. The first three months of the year and the last quarter are usually
accepted as the peak period for rheumatism, and while this is true of a curve plotted
to illustrate the above analysis a study of the figures for each month reveals that
only 59 per cent, of the rheumatic attacks occurred in these two quarters of the
year. In this series of 367 attacks of rheumatic fever only 58 per cent, were noted
in the first and last three months of the year, and while the incidence of sub-acute
rheumatism was heaviest in March and December, the general level was well
maintained throughout the year. Chorea among boys falls in incidence from May
D 1
Seasonal
incidence.