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of the heart of no serious import, and very few are organic lesions due to the effects
of rheumatism. An analysis of cases seen by the paediatrician for the first time during
the year showsthat only three children were found to have a heart condition, 1 was of
congenital origin, 2 were found to have slight murmurs, the lesions being regarded as of
no real significance, and could not be classed as cases of heart disease. This number is
only half the number found last year. The statement can again be repeated that rheumatic
fever, with its serious heart complications, is much less frequent than it was even a few
years ago. Restrictions in activity are no longer being imposed because of heart murmurs
of doubtful significance. No case of organic heart disease was recommended for heart
hospital school but one boy with this condition was admitted to the Elizabeth Fry Special
School during the year.
REPORT ON THE WORK OF THE PAEDIATRIC CLINIC
by
E.Hinden, M.D., M.R.C.P.
The work in the school health consultative clinics has followed the same pattern
as in previous years. There is however a striking falling-off in the number of children
referred to the clinics. I think this is due to a real improvement in the health of the
young community. The patient work of clinic doctors and health visitors is now bearing
fruit in healthier children, who are generally bigger and heavier than they were 20 years
ago, and more resistant to infection. There is no doubt that the killing infections of
infancy and childhood, diphtheria, tuberculosis, rheumatic fever are declining rapidly!
but unfortunately the non-specific respiratory diseases such as the common cold, tonsillitis
and bronchitis, are as active as ever and cause a good deal of invalidism and loss of school
time. There are some unlucky children, who seem to recover from one cough only to start
anotherj this is particularly true during their first year at school. This is because
the child exchanges the closed family circle for free mixing with hundreds of other children,
with consequent exposure to a very wide range of disease-producing agents. This cycle of
head-colds tends to weaken during the second year of school life, and rarely persists
after the age of
There is some evidence that repeated bronchitis may have more serious effects.
Some children develop a persistent low-grade infection of their lung bases, resistant
to treatment, which produces an intractable cough and impairment of general health. These
children also lose much time from school, and lack the wind to run about as vigorously as
other children even when they are well} and they are very prone to acute exacerbations of
their smouldering infection. But even these patients improve very much on a couple of weeks
hospital treatment followed by convalescence, and generally recover completely at adolescence.
We do not yet know the connection between this "ehronlc chest" in childhood and the chronic
bronchitis of later life.
I should like to express my gratitude to my colleagues, the assistant school medical
officers for consulting me about their charges, and to the family doctors for their courtesy
in permitting the referrals. I should also like to thank the pathologist at Whipps Cross
Hospital and the radiologist at St.Mary's Hospital, Plaistow, for continuing to extend to
me the facilities of their departments.
The paediatric clinics are administered by the West Ham Group of the Hospital Management
Committee but are held on the West Ham Education Committee premises as followss-
Rosetta School Clinic, Wednesdays from I.30 to 5.15 p.m.
Sophia Road, Custom House, E,l6.
Stratford School Clinic, Thursdays from 1.30 to 5.15 p.m.
84 West Ham Lane, E.15.
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