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(i) Heart Disease and Rheumatism.—Dr. Wilfrid Sheldon,
Physician in Charge of the rheumatism clinic, reports asfollows:—
"During the past year there have been 46 sessions with.
857 attendances, which is an increase of nearly 100 attendances
over the previous year. Of the attendances, 216 were
made by children attending for the first time, and 641 by
children being kept under observation. Of the cases attending
for the first time, 93 or 43% were found to have some cardiac
disorder. This is a higher figure than one would expect to
obtain among children referred to a rheumatism clinic, for
so often a rheumatism clinic is used as a dumping ground'
for children who suffer from any ill-defined and vague pains.
The figures given above show that this is not the case with
the clinic at Walthamstow, and this is chiefly due to the
care of the school medical officers in selecting cases suitable
to attend the clinic.
"Co-operation with the various medical and educational
departments has continued on the happiest lines, as shown
last year. This is indicated by the use which has been made
of such departments; for instance, during the last year 18
children were regarded as requiring hospital treatment, and
were referred to the appropriate out-patient department, and
three of them were admitted as in-patients. The removal of
tonsils and adenoids was considered necessary in 18 cases,
the operation being done either at the Connaught Hospital or
at one of the London hospitals. Thirty-four children were
referred for dental treatment, and in return the Dental Department
used the Clinic when it was necessary to decide
whether any particular child was fit to undergo an anaesthetic.
With regard to the Education Authorities, five children were
referred to the Physically Defective Schools, and arrangements
were made for five other children to attend half-time
at their elementary schools. A visit was paid to the clinic
by the Head Teacher of the Physically Defective School
in order that co-operation between the two might be further
advanced. It was found necessary to exclude 51 children
from school for varying periods.
"Much use has continued to be made of convalescent
homes, and I should like to state here how much I appreciate!
having the voluntary assistance of Miss Lewis of the
I.C.A.A. at each session of the clinic. It is largely owing
to her that out of 77 children referred for convalescence, only
two were unable to go owing to the refusal of their parents.
Anyone who has tried to arrange convalescence for large
numbers of children will know that this is indeed a low figure.