ACUTE RHEUMATISM.

New Zealand Herald, Volume LXIII, Issue 19412, 21 August 1926, Page 6 (Supplement)

ACUTE RHEUMATISM.

PROBLEM OF CHILDHOOD. BV F. JOHN rOYNTON, M.8., F.H.C.I'. There can be no question that the medical profession is making a great forward step, in the close attention it gives to the problem of acute- rlxeumatism in childhood. It is a disease of great national importance, and, to those who have been deeply interested in the subject, it has been a cause of 1 egret that the problem has not been approached in Teal earnest many years ago. but tuberculosis, cancer, and other diseases, together with the great war, have distracted attention. How many would imagine that this, disease reaches its maximum of frequency at the early age of ten years, or that of all the causes of organic heart disease acute rheumatism is the main one. When this is realised then it follows that the age at .which such heart disease arises is usually in childhood, and, in brief, during school age. Rheumatism in childhood attacks many organs as does tuberculosis. One of the problems, however, is that child sufferers' joints, though often attacked, are rarely, as irv adults, severely damaged. As to the cause, every year brings more evidence to favour the view originated by Dr. Alexander Paine, that it is a germ. But for this to produce the disease there may be secondary causes, and often a peculiar constitution. One point r>y which the infection invades the system is through the tonsils in an attack of tonsilitis, though it is not to be supposed that this is the only path. The important question that now arises is, can we our knowledge of prevention by more inquiry and more care ? If we can, we are striking at the roof of the greatest cause of organic heart disease. The figures of victims we know of in London must be multiplied by similar conditions in other towns and cities, and this at once indicates what a formidable and difficult adversary the medical profession is faced with. One of the problems and dangers is that parents, and even doctors, also can very easily be deceived because the disease is so amazingly treacherous. The heart disease of rheumatism is frequently quiet and painless at its onset. Another feature is chorea * or brain rheumatism, which seems -to attack girls more than boys, and is a frequent cause of absence from school. One great question to be handled is the reason for the frequency of brain rheumatism. My view is that educational strain is a great factor. If acute rheumatism in children began with acute pains and swelling in the joints, the position would be much easier for them at once, and perforce they would be put to' bed and the' doctor sent for. Unfortunately, vague pains, listlessness and pallor, a slight sore throat and a little shortness of breath are easily misinterpreted or overlooked and the damage done before alarm has been excited. I am convinced that once the medical profession and the public, working hand in hand, determine to improve the health provisions for the rheumatic child, there will be a striking diminution in heart disease. ___