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children. During the year 145 children were discharged from the
Clinic, some after their first attendance, because they were not
held to be rheumatic, some because, after several months' observation,
their rheumatic symptoms had faded out, and a few on
account of reaching school-leaving age. Those in the first two
groups are advised to report at once if any symptoms of rheumatism
should re-appear, while for those in the last group, advice has
been offered to the parents with regard to suitable employment,
when there has been a sufficient degree of cardiac disease to make
the choice of employment a matter of judgment on medical grounds.
''Other Defects.—Dining the course of routine examination,
other defects of health besides rheumatism are noted, but I am glad
to report that my impression of last year, to the effect that such
defects as carious teeth and septic tonsils are less frequent among
the new cases than when the Clinic began four years ago. In
this connection the figures for the last three years are not without
interest:-
1932. 1933. 1934.
Number of children referred for dental treatment 44 39 25
Number of children requiring removal of Tonsils
and Adenoids 25 14 11
"These figures seem to indicate that at any rate, some of the
common causes among the children are becoming less frequent,
and this is related to the prevention of rheumatism, inasmuch
as debilitative conditions make a child more prone to develop
rheumatic manifestations.
"School Attendance.—There is no doubt that the proper services
of the rheumatism clinic can only be realised by close co-operation
with the School Authorities, and once again it is a pleasure to
record the constant help that the Attendance Officers have afforded
me. During the year it was found necessary to exclude 65 children
from attendance at school for varying lengths of time. In addition,
facilities were afforded for six of these children to make a halftime
attendance at school. Twelve children were recommended to
attend a Physically Defective School. Last year the improvement
in the condition of several children who had received milk at
school was commented upon, and during this last year this recommendation
has been made more frequently, with most satisfactory
results.
"Convalescence.—During the year 74 children were recommended
for convalescence, which, curiously enough, is exactly the same
figure as in the preceding year, and of this number, 62 have
already been placed in suitable homes. The Work of Miss Lewis, of
the I.C.A.A., in arranging for the convalescence of these children