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16
of patients attending the Red Cross Curative Post is
so great that, unfortunately, there is usually an
interval between the first consultation and the time
of the patient being taken on for physical treatment.
This is unfortunate, as early treatment is so important.
We have also had to decide to limit the length of
time that we are able to treat those who are elderly
and come for symptomatic relief. We now give them
one or two courses of treatment and then stop, asking
them to report again at the end of a stated period,
usually two or three months. The X-ray and laboratory
facilities have proved of great help., both in
differential diagnosis and in following the progress
of our patients.
My own clinical research during the last year
has shown that the " stress and strain of city life,"
the bombing and personal worries are important
" trigger " and causative factors in both rheumatoid
arthritis and fibrositis and play a much greater role
than " infection." These are problems of what is now
called " psycho-somatic disease " and it is along the
lines of social medicine that they will be solved.
We need an Almoner or Social worker who can
help us to modify the environment such as the
housing, finance, diet, hours and type of work of some
of our rheumatic patients. She should both attend
at the clinics and pay visits to the patients' homes.
We need facilities to take some patients into Hospital
for a few weeks for investigation and treatment, and
we need an increase in both our technical staff and
equipment, if we are going to give good treatment to
our out-patients, relieve their pain and keep them at
work, whether it is in the factory, the office or in their
own homes.
I should like to express my admiration of the way
in which Miss Reed and her staff have helped to
tackle the " rheumatic problem."