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to these diseases. In 1924 the Ministry of Health
investigated the incidence of these diseases amongst
the insured population, and disclosed the fact that
nearly 1/6th of the industrial invalidity in the country
was due to "Rheumatism." In July, 1926, the Science
Committee of the British Medical Association published
a report on "Rheumatic Heart Disease in Children."
These inquiries revealed the close association of
rheumatism with poor, damp dwellings and the
importance of early detection of rheumatic infection
in the child and the need for proper care and rest.
In a certain proportion of cases connection of diseased
tonsils with rheumatic infection was confirmed.
Further research is required, but the indications clearly
point to the desirability of more effective measures
to ascertain the presence of rheumatic infection in
the child at the earliest possible moment, and to secure
adequate rest and supervision for children found to be
affected. By this means the number of children who
would otherwise develop into chronic cardiac invalids
may be reduced. Our Health Visitors are instructed
to keep a watchful eye on the toddlers they visit, or
see at the Welfare Centres, for signs of repeated sore
throat, slight chorea (St. Vitus' Dance), "growing
pains," joint pains and manifestations of nervousness
often accompanied by pallor. These children are noted
and kept under close supervision and the mothers
advised to give them additional rest. In the past
such children have been allowed to drift into heart
disease, and a great field of preventive work offers
itself for carefully-considered measures, which will
widen out as our knowledge of this infection is increased
by research. It must be remembered that for every
patient who dies of rheumatism large numbers are
seriously damaged and suffer from chronic inefficiency
and ill-health. In the meantime, attention to housing,
dampness in dwellings, by securing as much sunlight
as possible, decent wages and early detection and
careful treatment of the infected children are the
lines to follow up.