View report page

23
Total number of examinations made by Surgeon 668
Total number of cases discharged by Surgeon 88
Average number of examinations per session 44.5
Number of treatments given 8,236
Number of attendances for after-care 1,762
Number of sessions held—
Inspection 15
Treatment 441
Number of visits by Instrument Maker 40
Admissions to Hospital 24
Operated on in out-patient departments 5
Operations performed 23
Children transferred from Connaught Hospital 25
(e) Cardiac Clinic.—The Clinic continued under the clinical
charge of Dr. Mary Wilmers, F.R.C.P., who reports as follows:—
"The Walthamstow Cardiac Clinic, which was started in 1931
under the title of Walthamstow Rheumatism Clinic to fill an urgent
need for the supervision of children with rheumatic disease,
especially carditis, was closed at the end of 1956 for lack of patients.
Closure of the Clinic left a total of nine children to be transferred
to various paediatric clinics; this surely bears eloquent witness to the
decrease in the incidence of acute rheumatism over the last two
decades. Some interesting facts emerge from more detailed consideration
of the attendances, types of cases seen, reason for referral,
and seem worth commenting on, although the reason for the
changes noted are by no means always clear.
1932 was the first full year of the clinic and 45 sessions
were held, approximately one per week. The total attendances for
the year were 795 in the proportion of three new to five old cases.
In 1946 sessions were held roughly every six weeks, eight in all.
The total attendances were 142 and the proportion of new cases
to old was 5 to 4. Further analysis of the figures shows that
whereas just under half the new cases in 1932 were considered to
have acute rheumatism or heart disease, in 1946 less than one in
11 of new cases were so diagnosed. This difference alone would
account for a considerable falling off in attendances as children with
non rheumatic limb pains or functional cardiac murmurs would not,
as a rule, be accepted for supervision. One regular source of new
cases in the early years of the clinic was the Isolation Hospital. In
1932 nineteen children were referred after scarlet fever (of which
ten had cardiac lesion), sixteen after diphtheria (eleven had evidence
of heart disease) and three children after both scarlet fever and
diphtheria (all three had heart disease). In 1946 no child was
referred as a result of either of these diseases. In 1956, the last
year of the clinic, only four sessions were held and there was a
total of 34 attendances, of which only two were new cases. Neither
of the new cases was considered to have organic disease. While
the decline in referral of new cases during the last year may have