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296
The fact that the attendance at the Clinic has greatly increased
during the past three years is evidence that the parents appreciate
the supervision and advice given, and that they realise the value
of close medical observation of cases of juvenile rheumatism.
Grouping and Classification.
This continues to follow the scheme laid down in my Report
for 1931.
Group I.—Symptoms referring to the digestive
system and intestinal tract, e.g., abdominal
pains, constipation and lack of
appetite 35 cases
Group II.—Symptoms suggesting the presence of
toxaemia, e.g., aching limbs, lassitude,
headache 148 cases
Group III.—Symptoms suggesting a disturbance
of the nervous system, e.g., irritability,
disturbed sleep, nocturnal eneuresis,
fidgetiness 46 cases
Groups II. and III. include the majority of cases. In many
cases there is a combination of the symptoms specified in Groups
II. and III., varying in severity according to the type of case
observed.
Grouping of Cases (Classification of Dr. R. Miller).
1936. 1937.
Mild and Potential 119 (82.1%) 120 (76.0%)
Definite Active 16 (11.0%) 23 (14.5%)
Definite Quiescent 10 (6.9%) 15 (9.5%)
The "Mild and Potential" included those cases showing the
first initial symptoms of "growing pains" in highly-strung
children, with or without slight cardiac involvement.
The "Definite and Active Group" included, besides cases of
frank rheumatic carditis, those with marked physical signs of
Rheumatic Fever or Chorea.
Group IV.—Rheumatic manifestations. Total: 158 cases.
Rheumatic Pains 124 (78.5%)
Rheumatic Fever 11 (7.0%)
Chorea 12 (7.6%)
Carditis, Definite 13 (8.2%)*
*Slight 8 (5.1%)
*Marked 5 (3.2%)
Carditis, Suspected 1 (0.6%)
Tonsillitis 8 (5.1%)