Acute rheumatism in children in its relation to heart disease.

Date:
1927
Catalogue details

Licence: Public Domain Mark

Credit: Acute rheumatism in children in its relation to heart disease. Source: Wellcome Collection.

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    here in’ chronological sequence, but the reader should refer to Dr. Eastwood’s section of this report for the history of the bac- teriology of acute rheumatism, and for a discussion of the claims put forward for various organisms as the ultimate bacteriological cause in acute rheumatism. That the streptococcus plays an important rdle can scarcely be questioned, but it still remains © unproved that this réle is other than secondary. In 1902 Einthoven, following Waller’s work on cardiac measure- ment in 1889, introduced the modern electro-cardiographic method of studying the heart’s action, and in the same year Mackenzie published his “‘ Study of the Pulse,” based upon the results of his invention the Polygraph. In 1904 Aschoff published the findings by himself and Towara of fibrous nodes in the neighbourhood of the auriculo-venticular bundle of His* in cases of rheumatic carditis which have since been recognised as important pathological hall-marks of the disease. In 1906 the modern method of complete removal of the tonsil (as contrasted with the old method of cutting off by guillotine) was introduced by George Waugh at the Children’s Hospital, Great Ormond Street. Sutherland, in his “‘ Diseases of Children,’ published in 1907, advocated ‘prolonged rest in bed six months or longer if necessary {Yi . and sanatorium treatment for one or two years”’ for children threatened with rheumatic fever. In 1907 the Education (Administrative Provisions) Act, 1907, was brought into operation, which by its Section 13. 1(6) laid upon local education authorities the duty of medical inspection of school children and the power to make arrangements as may be sanc- tioned by the Board of Education for attendance to the health and physical condition of the children educated in Public Klementary Schools. In the same year the medical department of the Board of Education was formed, the first annual report of. the Chief Medical Officer being published in 1908, a year which also saw the publication of Mackenzie’s “‘ Diseases of the Heart.” In 1909 the Chief Medical Officer’s Report recommended the special medical supervision of rheumatic or cardiac children. The Annual Report for 1912 (pp. 95-104) contained an important section on heart disease and rheumatism, which included a number of definite recommendations, including that of a “ Residential School of Recovery,” in which children suffering from heart disease might receive treatment for a prolonged period, their rest and exercise being carefully controlled and every endeavour being made to establish their general health and physical fitness as well as to improve the action of the heart. This treatment, the report goes on to say, is especially needed by children recovering from recent rheumatism which has attacked the heart. At the annual meeting of the British Medical Association in 1913, F. J. Poynton, speaking on affections of the heart in childhood, recommended: ‘“‘ Modification of some of our convalescent , * Described by His in 1893.