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284
RHEUMATISM CLINIC
This Clinic is not in any sense a "treatment centre," but
is concerned with the diagnosis, supervision, advice and reexaminations
of all types of rheumatic infections in children.
A definite differentiation must be made between the chronic
rheumatic arthritic pains of adults and the acute and sub-acute
rheumatism of childhood.
The manifestations in childhood are varied; the most
common in the acute type being inflammation of the joints,
Chorea, Tonsillitis, and affections of the muscle and valves of the
heart; in the sub-acute and milder forms a series of mild sore
throats, slight indefinite pains and aches in muscles and joints,
frequently associated with a chronic insidious state of poor health.
The most serious complication is that of heart disease, and it
is in the prevention and supervision of these lesions that the Clinic
has its major usefulness.
Parents are becoming increasingly aware that "growing
pains" are not an indication of healthy physique but are due to
"rheumatics." Some now take the initiative in writing to the
Head Teacher concerning their child's " pains," and ask for an
appointment for the Clinic; an indication that the Clinic is becoming
more widely known and appreciated.
It is important in cases of heart disease that parents should
be advised immediately, so that further cardiac damage may be
prevented, but it is equally as important to be able to assure a
parent whose child has some heart involvement that the degree
and extent of the damage is not sufficiently serious to warrant
treating the child as an invalid for life, and that with care and
supervision a fairly normal life may be followed.
Difficult and severe cases have been referred to the OutPatients'
Department at the Croydon General Hospital, where Dr.
Preston, as in previous years, has very kindly given his assistance
and advice.
The Coombe Cliff Convalescent Home continues to pnove
an invaluable asset in cases where long periods of rest are
required, more especially in those cases where home conditions
are unsuitable and admission to a Home is desirable.