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68
One curious feature emerged when reviewing cases for 1937
and that was the high proportion of children who showed manifestations
of Chorea as against other evidence of Rheumatic
infections in childhood. Nearly half the total cases reported suffered
from Chorea, and of these the bulk were treated at the Borough's
Rheumatic Clinic at the Princess Louise Hospital.
Our arrangements with the Princess Louise Hospital whereby
the Hospital takes charge of Rheumatic cases for Acton, are very
satisfactory. Cases are referred to Dr. Aitken and thereafter it is
very certain that all that can and should be done for the child will
be undertaken. Cases are admitted where necessary to the Wards,
of the Hospital, all appropriate investigations are carried out and
advice given as to future conduct and care. It is often necessary to
send children who have suffered from Rheumatism in its various
manifestations, away for a prolonged period to a Heart Home. It
is urged by some authorities on the subject that every case should
be so dealt with and that the period of convalescence should extend
to a year at least, in order to lessen the chance of a recurrence
Unfortunately it is all too frequent for second and even third
attacks of Rheumatism to affect the same child and with each
subsequent attack there is greater risk that the heart will be per
manently damaged and less chance of the patient's escaping this
crippling disability.
Dr. Schlesinger (who is Physician to the West Wickham
Heart Home where so many of our children have been sent), writing
recently in The Lancet, has analysed a series of cases suffering
from Rheumatism. He contends that with the onset of puberty
there comes a remarkable decrease in the bad effects of rheumatic
relapses, and that if a child can only be steered carefully through
the dangerous years up to fourteen, there is more chance that
serious physical involvement may be avoided. After that age there
is less likelihood of relapse, and the patient's resistance appeals to
be higher.
The children who have been affected by Rheumatism in
Acton during 1987, range in age from 4 to 13. The most frequent
ages for onset were from 8 to 11. It has not been proved that as
earlier onset means a worse outlook except in so far that it leaves
more years for probable relapses before adolescence lessens the risk