Acute rheumatism in children in its relation to heart disease.

Date:
1927
Catalogue details

Licence: Public Domain Mark

Credit: Acute rheumatism in children in its relation to heart disease. Source: Wellcome Collection.

    92/114 (page 78)
    Children exhibiting any excerbation of choreiform movements are also confined to bed, though salicylates are not given unless a rise in temperature accompanies the condition. All other children at Baskerville are submitted to the ordinary hospital regime, which may be taken as representative of that in other Homes. _ The daily routine is as follows :— 7.20 a.m. ' « Rise, 8, 0 a.m. ee .. Breakfast. 8.30 a.m. 5S .. Play, rest, household duties. *9,20 a.m. ee op. AaNOLve ross 9.30 a.m. is .. Prayers, singing. 10-12 a.m. + .. Morning school. 12. 5 p.m. rs J). UESe Nerve Hests* 12.15 p.m. ak i. SINNNETS 1.0-2.15 p.m. .. .. Resting, play, free walks in garden. 2.30—4.30 i .. Afternoon school. 4.35 p.m. = : aap Nerve rest. 4.45 p.m. ~ Spore Ws. 5.15-8. Op.m. .. .. Recreation andbed. ‘Time of going to bed depending on age or stage of con- valescence. - TREATMENT OF SPECIAL DEFECTS. Facilities should be provided at these institutions for the treatment of special defects, such as dental disease and enlarged tonsils and adenoids, which are intimately associated with the ‘rheumatic state.’ Great emphasis is now laid at Baskerville Home on the necessity for complete tonsillectomy in the prevention of carditis. Every patient is closely examined on arrival and if a previous tonsillectomy appears to have been incomplete, it is completed by actual dissection. PHYSICAL EXERCISE, Graduated exercise has an important place in the treatment of the cardiac child. ‘To decide when the period of complete rest. . must end, and the re-education of the heart begin, is a matter which must necessarily be decided on the merits of each case. A safe rule, however, adopted by A. P. Thomson at Baskerville, is to insist on unchanging physical signs for three weeks before any exercise is allowed. When convalescence is complete the child is allowed moderate walking exercise. As a precaution against over exertion children in ascending stairs have to walk backwards. Later croquet and clock golf are allowed, but no games which involve chasing a moving ball. Finally, drill for periods of ten minutes and simple country dances with slow music are performed. At the Edgar Lee Home physical drill consists of breathing and trunk exercises only, and is taken in the open air for ten minutes each morning. * “ Nerve rest.”—All children sit or lie silent with their eyes closed for 10 minutes, and are taught to relax all their muscles. This procedure is particularly valuable in the treatment of chorea.