Rheumatism and the Child

Rheumatism is to be regarded as a specific bacterial disease the infective organism being a short-chained streptococcus which is most probably always present in the alimentary canal and particularly in unhealthy tonsils. One attack of the disease confers no immunity against recurrence. The streptococcus is probably not the sole cause of the disease but as to what the other factors are,nothing is definitely known. Exposure to wet and cold, fatigue, environment and heredity are probably factors in the causation of the disease. As regards treatment rest in bed, and in many cases, prolonged rest, is essential and the means for giving these cases the necessary rest during convalescence should be provided. This entails the provision of special institutions or homes. With regard to the treatment of the disease by drugs sodium salicylate in sufficient doses,and combined with sodium bicarbonate is the most efficacious. The question of prophylaxis is difficult owing to the lack of knowledge of the complete aetiology of the condition. Better housing, avoidance of exposure, the wearing of suitable clothing and the education of the public in matters of health would probably lessen the incidence of the disease and early and thorough treatment would prevent the development of the more serious manifestations