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Where these signs were present in a case, who also shewed
some cardiac dilation accompanied by breathlessness on exertion,
the diagnosis became more certain and passed into the definite
and quiescent group. In these cases anaemia was frequently
present, being recorded in 16 cases out of a total of 36 definite
cases.
Malnutrition was frequently noted, and an expression of
nervous tension completed a clinical picture whose only counterpart
may be seen in children the subjects of glandular, mesenteric,
or other forms of tuberculosis.
The definite and active group comprised cases of frank
rheumatic carditis, as shewn by well marked physical signs with
a history, or the presence of rheumatic fever or chorea.
Some cases of organic heart disease, whose origin'could not
be otherwise accounted for, were placed in this group.

One child had had both rheumatic fever and chorea.
Rheumatic Fever Cases.
There were 7 children who gave a definite history of rheumatic
fever. Of these 2 had sound hearts, 5 had definite carditis.
Chorea Cases.
There were 11 cases of chorea. Of these 1 had had definite
carditis, 2 suspected, and 8 sound hearts.