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154
Speech.
Defective articulation was noted in 7 children only, excluding the
children with cleft palate. All, except one girl of ten, were infants.
Twelve children were stammerers, eleven boys and one girl.
Heart and Circulation.
ANÆMIA—Eight children were considered to be anæmic, three
boys and five girls.
HEART DISEASE—A mitral systolic murmur, not considered to
be due to organic heart disease, was heard in nine children, three boys
and six girls.
The number of children with organic heart disease was 18 (0.44
per cent.). Two of these cases, one a boy and the other a girl of five
years of age, were suffering from congenital heart disease; the others were
all cases of mitral regurgitation. The percentages of children with heart
disease at different ages were:—

Organic heart disease was thus more frequent among girls.
In one child, a boy of ten years of age, the heart was on the right
side, the apex beat being in the fifth right intercostal space, and cardiac
dulness extending from there to the sternum. This is the third case of the
kind found during the course of about eighteen thousand inspections.
RHEUMATISM AND HEART DISEASE—Excluding the two cases
of congenital heart disease, we found that of the 16 other children with
organic heart disease, two had a history of a previous attack of
rheumatic fever or rheumatism. There was a history of rheumatic fever
or rheumatism with 28 other children, who showed no evidence of organic
disease of the heart.
As these figures do not seem at first sight to establish a very close
connection between rheumatism and heart disease, the figures of the last
three years, dealing with these conditions were collected. They are as
follows, counting the figures of those years, 1910, 1911, and 1912,
together:—