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 year 1926, including 19 children admitted to the wards as emergency cases through the Casualty Department, was found to be 508 cases, of Whom 231, or 45-5 per cent., were boys and 27 7, or 54:5 per cent., were girls. Of these TEES 111, or 21-9 per cent., had undoubted cardiac lesions and, in addition, 108, or 21-3 per cent., had a cardiac condition suggestive of organic damage. The difficulty of treating the disease in children living at home and for the most part under conditions which preclude their having the necessary rest and quiet appears so great that it is obvious that those cases requiring rest in bed cannot be adequately nursed in their own homes and must be admitted to some institution. This is particularly necessary where more than one child in the family is affected. Accommodation for cases of rheumatism appears to fall far short of the demand. 34 cases were admitted to St. Thomas’s Hospital and 14 to the infirmary or other hospitals during acute stages of the disease. 68 children with more chronic conditions were sent to special institutions or convalescent homes. 392, or 77-2 per cent., were treated as out-patients at home, many of whom would have been recommended for admission to institutions had. accommodation been obtainable when required. 2nd Series (Prolonged observation). In a series of cases from 400 families under special observation from 1923-4 onwards, the number of children of twelve years or under found to have attended the hospital for rheumatism was 473, of whom 208, or 43-9 per cent., were boys and 265, or 56-1 per cent., were girls. Of these children 141, or 29-8 per cent., had cardiac lesions, and 110, or 23-3 per cent., had a cardiac condition suggestive of organic damage. This percentage is significantly higher than that found in the 1926 series, which contained a higher proportion of early cases. It was found difficult to estimate the relapses sustained by these children owing to the fact that the disease appeared to be chronic and indefinitely progressive in its course. In 38 out of 257 cases under observation for two years or more, or 14:7 per cent., no relapse as such was observed, but in 19 of these cases only could it be considered that the disease was controlled. 96, or 37-3 per cent., had had one relapse, and 123, or 44-0 per cent., had had two or more relapses. Of the end results of treatment nothing can be said without re-examination of the children at some future date. GENERAL CONCLUSIONS—OUT-PATIENTS. Though, as has been said before, figures based on cases attending a hospital probably tend to show up the darkest side