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41
This further hospital accommodation removed to some extent the difficulty
of dealing with boys, which had been experienced from the beginning of the scheme,
and rendered the average age of the children admitted to hospital rather lower than
it had been in previous years. With regard to this latter point, the average age ol
admission for residential treatment remained constant at ten years from the beginning
of the rheumatism scheme, until the past year, since when it has fallen to 9 • 5, and this
lowering of the average age was accentuated from July when further beds became
available. The point is of some importance since the average age of onset of rheumatism
in all cases dealt with under the scheme since 1926 is eight years, and the
further from this age the child is before coming under treatment, the more likely
are cardiac complications to ensue.

The majority of the cases nominated by the school doctors were already under
treatment either by a private doctor or at a hospital.

The number of nominations, as was noted last year, does not fall off as would
be expected in the summer months. The fall in the nominations in August is due to
the school holidays, and to the closure of the rheumatism supervisory centres and
of certain of the out-patient departments of voluntary hospitals.
The number of children admitted to hospital during the year was 655 (boys 242,
girls 413); viz., Queen Mary's Hospital for Children, 365 ; High Wood Hospital
for Children, 278 ; and the Downs Hospital for Children, 12. This number (655)
comprised 591 new cases, 8 cases admitted twice during the year, and 56 children
who had had residential treatment under the scheme in previous years and were
re-admitted for treatment during the year.
Of the 591 new cases, 59 children (articular rheumatism 49, chorea 10,) were
acutely ill, and were admitted to hospital within a few hours. In many cases, urgent
admission was only made possible by the willing co-operation of the medical superintendents
of Queen Mary's Hospital for Children and High Wood Hospital for Children,
a co-operation which is gratefully acknowledged.

Nomination
of children
for residential
treatment.
Children
admitted to
hospital.