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It was the Invalid Children's Aid Association in this country
which took the first step in dealing with rheumatism in childhood
and now no country has a better organisation than this. A special
convalescent home gives the child's heart the best chance of recovery
in the best circumstances. If the child is left in its own home
where the other children have no disability, where the mother is
overworked and has no time to see that the affected heart is not
being overstrained, or where overanxiety leads to the insistence that
the child does nothing at all, where is the chance of improvement
compared with regulation of life, exercise, and education found at
these special convalescent homes? It has been said that ideally,
every child whose heart has been affected by rheumatism should
spend from 12-18 months afterwards at these special homes to
lessen the chance of a recurrence.
Most acute rheumatism occurs in poor rather than rich
homes. It is not unknown among the well-to-do but it is much
more frequent in a poorer stratum of society. Overcrowding,
insanitation, dampness and deficiency of diet have all been cited
as contributory factors. It will be interesting to see whether the
large number of houses that are being built for slum clearance
areas will result in a diminution of acute rheumatism in children
owing to increased space and air or in an increase if these houses
have been too rapidly and flimsily constructed to be weather-resisting
in a climate such as ours.
Acute rheumatism in Acton is at present, steadily on the increase
and has been so since 1931. In 1936 there were twice as
many cases as in 1935 and 1935 contained as many cases as the years
1931-1934 inclusive. It is hard to explain this. Acute rheumatism,
according to expert observers of the disease such as F. J. Povnton,
will come in waves some years and it may be that we are now approaching
the crest of one of these waves. It is also a well known
fact that once the need for certain facilities is recognised, the cases
to be treated wall follow. Acton has a Rheumatic Clinic for its
school children at the Princess Louise Hospital for Children. Here
all suspected and diagnosed cases of rheumatism are referred and
treated and when it is advised, arrangements are made for admission
to an appropriate convalescent home. Acton children are
not infrequently admitted to the West Wickham and the Edgar
Lee Heart Homes and the Heart Home, Lancing. It is possible
that these facilities are becoming more widely recognised and made
use of and that this, in part, may account for the increase in rheumatic
cases noted among school children.