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.

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    a el _— eee remarkable. In the 300 cases from Virginia, owing apparently to the great incidence of hypertention and syphilis upon the negro patients, the cases of rheumatic heart disease formed only 22 per cent. of the 300 patients as against the 46 per cent. patients whose heart disease was due to hypertention. Even in aortic regurgitation (a condition peculiarly likely to be syphilitic in origin) 1. M. Harmer* found that 27-2 per cent. of the cases, all between 20 and 70 years, were undoubtedly rheumatic in origin compared with 37-2 per cent. of cases undoubtedly syphilitic positive. The length of time between the first attack of rheumatic fever and the patient coming under observation for aortic regurgitation varied from 1 to 40 years, but the average period was 11-6 years. IV. (1.) Predisposing Conditions. The report of the Child Life Investigations Committee of the Medical Research Council, “Social Conditions and Acute Rheumatism,’’t recently published, embodies the result of intensive investigation into many aetiological factors concerned in the causation of ‘acute rheumatism in children. Such important factors as heredity, environment, infectivity, housing, dampness of house and site, overcrowding, the incidence of sore throat, and seasonal variations in incidence, have been investigated and are reported upon with a thoroughness which has scarcely been equalled before in the study of acute rheumatism, and which renders the discussion of these aspects of the problem unnecessary here. The reader is, therefore, advised to study the Medical Research Council’s report before or concurrently with the present one. It may, however, be convenient to state here that the results of the investigation of the occurrence of rheumatism in the families of rheumatic and control children may be said generally to confirm those found by other workers. There was a significant difference between the incidence of rheumatism among the living members of the families of rheumatic children as compared with those of the control series. It was also found that in 260 out of the 721 rheumatic families, or 36-1 per cent., there are one or More persons in addition to the rheumatic patient suffering from rheumatism. Precise evidence of “infection ” of healthy persons by a case of rheumatism has not been obtainable. Of 382 persons sleeping in the same room as 192 rheumatic children, 50, or 15-0 per cent., showed evidence of acute rheumatic infection. No comparable figures could be obtained from the control families, but the incidence of acute rheumatic infection among those in close * TI, M. Harmer, University College Hospital, ‘“‘ Heart,’? 12th March, 1926. , + Special Report Series No. 114, 1927.