The importance of this subject can hardly
be overestimated when one realizes that rheumatism in
childhood is responsible for nearly all the cardiac
disease in early life and a considerable proportion
in adult life, and that cardiac disease is responsbile
for a very large share of the death rate of this
country. In 1921 the Registrar General found that
11.76% of deaths at all ages and from all causes in
England and Wales were due to heart disease and this
did not include diseases the vessels.
The frequency of the condition is not fully
realized, probably because its minor symptoms owing
to their apparent triviality are often ignored or
ascribed to something else.
The traditional belief amongst the general
public that children cannot have rheumatism dies hard
and often prevents an early diagnosis being made.
Only too often does one first see these cases when
irreparable damage has already been done to the heart.
These considerations, together with the
varied clinical manifestations, the unknown etiology
and the difficulties of treatment are in the author's
at work give him ample scope for studying the disease
in its various guises and for ferreting out possible
predisposing causes and contributing factors in the
In the following thesis an attempt will be
made to put together a few observations on the
condition as met with in general practice, and to
bring these phenomena into their appropriate
relation with one's view of rheumatism as a whole.