View report page

45
whilst children in whom rheumatism is not definitely diagnosed attend every six
months—unless earlier attendance becomes necessary.
The Queen's Hospital rheumatism supervisory centre has had a strenuous
year, as has already been noted. Dr. Winnicott reports that the average attendance
per session was 33.6. He emphasises the value to the centre of the increased facilities
for residential treatment provided at Queen Mary's Hospital for Children, Carshalton,
and High Wood Hospital for Children, Brentwood, especially in the treatment of
early or doubtful cases. Dr. Winnicott records his interesting experience at the centre
that it is very unusual for carditis to develop in a child attending the centre, except
in one already known at the first visit to be subject to rheumatic arthritis or chorea.
He is of the opinion that further work at the rheumatism supervisory centres may
reveal that what is at present suggested by the words "pre-rheumatic" and "prechoreic"
is without basis on clinical fact.
Dr. Preston has submitted a report on the Downham, "Elizabeth Bullock"
and Putney rheumatism supervisory centres. This report is of so interesting a nature
that it is printed in entirety. The report is as follows :—
In Table I are shown the numbers of cases attending the three centres during the year and in
Table II the total number of inspections and re-inspections actually carried out.

At Downham there has been an increase on the numbers seen in the previous year, and a
few extra sessions were necessary in order to deal with new cases. At this centre, 75 per oent.
of appointments made for new cases and 73 per cent, for old cases were kept.
At "Elizabeth Bullock" centre, the figures are practically identical with those of the previous
year, 81 per cent, of appointments made for new cases and 67 per cent, for old cases were kept.
The Putney centre (opened in May, 1930) has continued to justify its existence. Regular
sessions are still held only once a month, but it has been necessary to hold three extra sessions
during the year to avoid congestion. It may be that fortnightly sessions will be required in the
near future. At this centre, 81 per cent. of appointments for new cases and 64 per cent, for old
cases were kept.
Table III shows the discharges, etc., from the three centres; the policy of keeping under
continued observation those cases considered to be definitely rheumatic (even though free from
active symptoms) has been continued; but as a result of continued observation, it has been found
possible to discharge many of the doubtful cases still under observation in 1930.
The smallness of the number of cases who repeatedly fail to keep appointments and thus
"get out of touch," continues to be a gratifying feature.
Queen's
hospital.
Downham,
"Elizabeth
Bullock" and
Putney.