Rheumatic manifestations in childhood and adolescence

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 etiology. 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