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98
RHEUMATISM.
Acute Rheumatism is a disease of childhood and youth whose
effects persist to adult life and is the cause of much of the heart
disease met with in adolescence and later in life.
It was first named and described some 4 centuries ago by
Baillon and referred to by Sydenham in the 17th century as attacking
the young and vigorous. It was not however, until well into
the 19th century that the disease found a place of any importance
in the books on diseases of children and not until the 20th century
were attempts on any large scale made to use the knowledge gained
to avert or alleviate the condition. Much work was done by many
clinicians, pathologists and bacteriologists on the causation and
course of the disease in the latter part of the 19th century and up
to the present day work is still being eagerly carried out. Many
theories have been put forward, discarded, amended, and even
now the cause of rheumatism in childhood is the subject of much
research.
The association of Rheumatism with heart disease was first
pointed out in 1778 and with the invention of the stethoscope in
1816 the association was established. In 1809 the connection between
Chorea and Rheumatism was first noted and the observation
was confirmed in 1821 by Copeland. Later, in 1847, the connection
was beginning to be acknowledged and by 1870 it was generally
accepted.
During the present century increasing interest has been taken in
this subject and it has been realised that if heart disease is to be attacked
in the adult population, prevention must be practised among children.
From 1920-1924 investigations in London and Glasgow were
carried out, and the results published by the Medical Research
Council, and between 1920-1927 the British Medical Association
held meetings and published reports on " The care of the rheumatic
child " and Sir George Newman prepared a special report
on " Acute Rheumatism in children and its relation to heart disease'.'
F. J. Poynton was one of the most earnest workers on the cause,
care and treatment of rheumatism in childhood, and as far back as
1912 he was saying that "special convalescent homes will be the
means of averting much of the chronic heart disease of rheumatic
origin that ruins so many lives and is the despair of the physician
and our general hospitals." Unfortunately Dr. Poynton was not
listened to and it was left to America to show us the way when
they established special cardiac clinics for the control and care
of children suffering from rheumatism but not ill in hospital.