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280
RHEUMATISM CLINIC
During 1933 it has been impossible to hold this Clinic more
often than once a fortnight—24 times in all. This is not often
enough, and it is a pity, for although all new cases had been
seen and the waiting list reduced to nil at the end of the year,
re-examinations were much too infrequent, and many cases have
been waiting over a year for re-examination which ought to
have taken place a few weeks after the previous examination. The
Clinic is not held for treatment, but is a supervisory centre. It
cannot function as such if re-examinations are at such infrequent
intervals. The supervision of rheumatic children is good preventive
work which is not likely to be undertaken by the general
practitioner amongst elementary school children. It is not true
economy for the Clinic to be held at such infrequent intervals
that its proper functions cannot be carried out.
The number of new cases is almost the same as in 1932. It
is much smaller than the numbers in the first four years of the
Clinic, and it will be interesting to see if the figure is now
stabilised.
Dr. Preston, at the Croydon General Hospital, has again
been very helpful in seeing doubtful and difficult cases and
giving his advice on cases sent to him at his Out-Patients Clinic.
The Convalescent Home at Coombe Cliff is a great boon for
children requiring prolonged rest which they are not likely to get
at home.
Parents are certainly being educated about the rheumatism
of childhood and are coming to recognise the symptoms and
appreciate their significance. Growing pains are much less often
ignored than formerly. When juvenile rheumatism and the
rheumatism of grown-ups are given different names, a great
stride forward will have been taken in the prevention and supervision
of the former. At present it is inevitable that parents
who have never been instructed to the contrary will associate
rheumatic pains in their children with their own chronic aches and
attach little importance to what, in their case, is little more than
an annoyance, but in children may lead to lifelong invalidity.