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These facilities, provided on premises which are easily accessible and well known
to the parents and children, should encourage acceptance of treatment at a stage when it
will be really preventive.
Valuable work is also done at the Elizabeth Fry Special School where deformities
the aftermath of anterior poliomyelitis, hemiplegias and spastic paralysis are dealt with.
In the same way much good is done by the visits to the Fyfield Open Air School for delicate
children where those with asthma, poor posture and general lack of tone are given treatment.
In these cases the physiotherapist also gives guidance to the nursing staff so that they
can continue the relatively simple treatment in between her visits. This arrangement has
worked satisfactorily.

HEART DISEASE AND RHEUMATISM. Under the Ministry's classification all conditions of
the heart and circulation are grouped together under one heading. During the year under
review 182 cases were referred at Periodic and Special Inspections for treatment and 149 for
observation. Separate statistics are not available for the individual conditions making up
this total, but it may be said that the majority consist of cases of anaemia and functional
disturbances of the heart, and only a very few are organic lesions due to the effects of
rheumatism. As Dr. Hinden indicates in his report on the work of the Paediatric Clinic
(Page 78 ) rheumatic fever in childhood appears to be declining, even when measured over the
post-war years alone. The cause of this gratifying improvement is unknown, but it is tempting
to ascribe it to the better state of nutrition which children have enjoyed in recent years, and
perhaps also to a general all-round improvement in the standards of child-care. It may be
that childhood rheumatism, like infant mortality and tuberculosis, can be regarded to some
extent as a broad indication of the success or failure of a society to achieve good living
conditions for the bulk of its citizens. Judged on that basis, it would seem that good
progress has been made but more yet remains to be done before all is as well as it can be.
No cases of organic heart disease were recommended for Heart Hospital Schools but one
boy and one girl with this condition were admitted to the Day Special School during the year.
During the year 1952, the number of children treated as in-patients in special heart
schools was 5, (4 of which were not admitted through the Local Authority) one boy at St. John's
°Pen Air School, Woodford, and two boys and two girls at West Wickham.
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