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44
responding to a mortality rate of 1.18 per thousand
of the population. The following table gives the age
and sex distribution of persons who died of diseases
of the heart during the year:—
0-1
1-2
2-3
3-4
4-5
5-10
10-20
20-35
35 45
45-65
over
65
Males 1 — — — — — 3 3 3 33 42
Females 2 - — — - l 3 6 4 40 54
Males 85
Females 110
In addition to producing a high death-rate, heart
diseases are responsible for much disablement, distress
and financial loss. With regard to their causation,
speaking broadly and excluding the less common
causes the cases fall into three classes which have been
called the rheumatic, arterio-sclerotic and syphilitic
types.
The first type of case commences in early life,
generally as a result of acute rheumatism, but in rare
instances it may result from one of the acute fevers
(scarlet fever, diphtheria, influenza, pneumonia).
Probably 80 to 90 per cent. of cases of organic heart
disease in childhood are caused by rheumatism.
The second class of case commences in middle life
or old age as a result of degenerative changes in the
heart and blood vessels, including arterio-sclerosis,
and is due to a variety of causes among which are
actual or premature old age, chronic alcoholism,
habitual over-eating, especially in persons engaged in
sedentary occupations, prolonged overwork or overstrain
of the muscles or nervous system, and high
blood pressure. These conditions are much commoner
in men than in women. When the causes of
these degenerative diseases of the heart and blood
vessels are considered it is clear that they are, to some
extent, preventable. Education of the public, and