HEALTH NOTES

Waipa Post, Volume 45, Issue 3212, 4 August 1932, Page 8

HEALTH NOTES

RHEUMATISM

(Contributed by the Department of Health.)

Rheumatism is a disease well known in temperate climates, and in New Zealand we are by no means exempt from it.

The importance of climate is shown by the special prevalence of rheumatism in countries within the temperate zone and by its' definite seasonal incidence; it is comparatively very rare in the trop.cs. The majority of cases occur in May and June, and the fewest in the less-humid months of December and January. Heredity has been long recognised as a factor, and an imperfect dietary has been heid for many years to be associated with it. Poverty and over-crowding and dampness of dwelling houses aggravate the disease, though, statistics indicate that the incidence of infection falls mainly on the children of the moderately poor, and to a less degree upon those of the well-to-do and the very poor. Further, it appears true that rheumatism is a disease of 1 the inhabitants of industrial towns rather than of rural districts.

Investigations into '-"the excitingcause of rheumatism point to the existence of a micro-organism or germ. Apparently scarlet fever may act as a strong predisposing cause. The'predisposing ca.uses which favour the development of the disease are of outstanding importance. The disease is emphatically nn o of school years, the onset as a rule being between 5 years and 15 years. There is a reasonable amount of evidence to show that infection generally occurs through the throat. Unhealthy throats caused by diseased tonsils, adenoids, and decayed teeth are common in childhood, and provide an entry through which the micro-organism of rheumatism invades the body. Rheumatism in children manifests itself in a different form than in older people. In adults the typical acute rheumatic attack is accompanied by painful joints, fever, and profuse perspiration, and is liable to be associated with various complications, especially in connection with the heart. In children in fully half the cases there is little or no joint affection, and fever may be comparatively slight. In many cases the only symptoms noticed during the onset of a serious rheumatic attack in a child are languor, pallor, and wasting, although extensive changes in the heart may have already occurred. ItMs this characteristic of the rheumatic poison to do serious damage before being recognised that makes essential not to minimise the importance of minor rheumatic manifestations in children. For instance, the popularly-named " growing pains" are rheumatic in origin, and indicate the necessity for care.

Dr Sheldon, in the Lancet, states that in 52 out of 266 children with rheumatic heart disease pains in the limbs over several months were the only evidence of rheumatism that pre-

ceded the discovery of the heart lesion. Though muscular and ligamentous structures are most attacked, rheumatism in ch.idren often affects the nervous system, producing symptoms of chorea, the disease commonly known as St. Vuus' dance. PREVENTION.

Every child who suffers from " growing pains'" should be medically and careful supervision of all" shght ailments is available. Defective teeth, dischargh. ears, enlarged tonsils frequent sore throat, and any form of catarrh should be carefuby treated. The clothing of children, especially those with rheumatic tendencies, is very important. .Such chi.dren, especially in winter, should wear woollen garments next to the skin, care being taken to cover the extremities; warm stockings and watertight shoes in bad weather are essential. Undue exposure to wet and cold should be avoided. 'Residence in a dry climate, when possible, is beneficial.

The importance of rest and fresh air for all children cannot be exaggerated, and for the rheumatic child they are doubly necessary if the weakened heart and nervous system are to become strong. It is advisable to enforce the habits of an invalid upon a child convalescing from rheumatic fever, but strenuous exercise, whether mental or physical, should not be taken until recovery is complete. The details of the chbd's life should be regulated by medical advice. Competitions, whether or intellectual, should be avoided. The need for the after-care of the rheumatic child is as yet imperfectly realised. If possible there should be provided means for the institutional treatment of rheumatic children in the course of which they can receive controlled rest with plentiful sunlight and fresh ail". It can be laid down definitely that a child suffering from an attack of rheumatic fever should be confined to bed for a period of at least six weeks, and should be under strict medical supervision for some months. A periodic health examination by the family medical practitioner or by the school doctor is a valuable safeguard agamst the recurrence of the disease. We wish to emphasise the fact, however, that it is unnecessary, in considering the future of any_ child suffering from rheumatic manifestations, to hold too gloomy a, view, as early recognition of the jij.-ea'se and appropriate treatment hold out great prospects of defhr'te amelioration and even of absolute cure.