London's Pulse: Medical Officer of Health reports 1848-1972

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Walthamstow 1934

[Report of the Medical Officer of Health for Walthamstow]

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30
has been much appreciated, while her presence at the Clinic with
her knowledge of local housing and living conditions is of the
greatest help in deciding what is the best course to pursue with
many of the children.
"Prevention.—The follow-up of children who have been discharged
from the Sanatorium after scarlet fever and diphtheria,
and the reference to the Rheumatism Clinic of any such who are
suspected of early cardiac or other rheumatic manifestations, has
now become a regular part of the Clinic's work, and I have no
doubt at all that this has resulted in the detection and immediate
treatment of many children whose rheumatism might otherwise
have progressed to more serious and crippling degrees. Of 15
children who came to the Clinic after scarlet fever, no less than
9 were thought to have some cardiac defect, while of 11 children
who had diphtheria, 7 were found to have some abnormality of
the heart. With the help of Mr. Rushton, I have analysed the
after-history of all those children attending the Clinic since 1931
whose rheumatism had first been noted after scarlet fever or diphtheria.

The results are shown in the following table:—

1931.1932.1933.1934.
Number of cases referred to Clinic41413225
Number discharged after 1 attendance6883
Number kept under observation for several months, and now discharged with normal heart2022915
Number discharged on account of over age or through reference to private doctor or hospital12495-
Number remaining under observation with cardiac defect37107

"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 are all 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.
Four children are able to put in full attendance at their school,
but are still held to be unfit to do games or exercises, while two
children are at present attending the Physically Defective Centre.
Lastly, five 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