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49
"From the point of view of the utility of the clinic, perhaps
the most interesting group of these children is the last,
namely, those who have been kept under observation on account
of their persistent cardiac defects. The history of these 27
children is as follows:— 15 of them are remaining under observation
because of a persistent mitral murmur, but all are not only
attending school full time, but are able to join in the school
games and exercises, and are in fact leading a normal life. It is
particularly interesting that one of these children was at one
time sufficiently crippled with rheumatism to have to attend the
Physically Defective School. 4 children are able to put in full
attendance at their school, but are still held to be unfit to do games
or exercises, while 2 children are at present attending the Physically
Defective Centre. Lastly, 5 children are remaining under
observation at the Clinic for heart defects which are regarded
as having dated from birth.
The purpose of this analysis has been to see whether the
follow up of these children suspected of rheumatism after scarlet
fever and diphtheria is worth while, and it seems to me that the
evidence is in favour of continuing this preventive work, for it
is a striking thing that of the 27 children sent to the Clinic in
this way, and all of them found to have cardiac mischief, no less
than 16 are now able to lead perfectly normal lives."
Diphtheria Immunisation.— The Clinic was carried along the
lines detailed in the report for 1933. As far as possible, many
children under five years of age were Schick tested in addition
to all children over that age. These pre-Schicks in young children
were done mainly as a control in the use of alum precipitated
toxin which was brought into use in children under eight years
of age at the end of the year. In the few cases done with this
prophylactic, there was no failure to obtain a negative post Schick
four weeks after the injection. Children over eight years of
age were immunised either with toxoid antitoxin or flocoules (three
doses at weekly intervals with a post Schick one month after the
last).