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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    the Invalid Children’s Aid Association. It cannot be said that such facilities are available to the same extent to rheumatic children in the general population. From the account given of the difficulties met with in home nursing, where it is necessary for a child to be kept in bed for any length of time, admission to an institution is essential. Yet even with the highly organised machinery available at St. 'Thomas’s Hospital, 77-2 per cent. of the children were treated in their own homes, largely because there was no other means of dealing with them. VI. Seconp Series or Cases (under observation for several years). THe NUMBER OF CASES OF RHEUMATISM IN CHILDREN OF 12 YEARS or AGE AND UNDER FROM 400 FAMILIES UNDER OBSERVATION FROM 1923-4 ONWARDS. 1. The wineidence of cardiac wvolvement. During the investigation for the Child Life Committee of the Medical Research Council, 400 families each containing at least one child attending the hospital for rheumatism were investigated. This investigation was begun in 1923, and the children were not selected in any way except as cases of undoubted rheumatism. At the same time, not every case of rheumatism attending in the department during the years 1923 or 1924 was investigated. Cases of children living beyond a certain radius or on the north side of the river, cases of adopted children whose family histories were unobtainable, and surplus cases when the sample of 400 had been obtained were not investigated. The cases were ear- marked for investigation each week in such numbers as could be undertaken at the time, and there was no selection of any particu- lar type of case. The medical records of these children, together with those of such of their brothers and sisters who were under 12 years of age, and also under treatment at the hospital for rheumatism, have been examined and the progress of the disease up till the time of the last attendance noted. The classification of the cases is difficult as a child’may have suffered from various manifestations of the disease at different times and so cannot be satisfactorily placed under one heading. In making the following attempt at classification, the plan has been adopted of dividing the cases into three groups. 1. Under the heading of Rheumatism, those cases who were brought to hospital suffering from some definite form of rheumatic manifestation such as rheumatic fever, organic heart disease, chorea or nodules and who gave a history of onset with pains. 2. Under the heading Chorea, cases where the child was brought to hospital definitely for chorea, itself. 3. Under the heading of Rheumatic Carditis, those cases where the child is brought to hospital for symptoms which result from a cardiac lesion, where the rheumatic history, if present, is very