Rheumatism And The Heart
( Originally Published 1921 )
It is common knowledge that rheumatism is a cause of heart disease, but few people have any idea how large a number lose their health and their lives every year from this cause.
Inflammatory rheumatism is due to infection, just like pneumonia or typhoid fever, and it is a disease that is hard to avoid, because so little is known of the germ that causes it. The disease has a close relationship to tonsilitis, and for that reason children's tonsils should never be neglected. When a child's tonsils are removed, the chance of the child's developing heart disease from rheumatism is vastly diminished. In most instances when rheumatism spreads from the tonsils to the whole body, the joints are involved, and later on the heart becomes the seat of the inflammation. Quite often, however, I find a person with the evidence of serious rheumatic damage of the heart who has never had anything but throat trouble to account for it.
When the heart is inflamed from rheumatism, the whole of the organ is involved the covering of the heart, or pericardium, the heart muscle, the fiber structures, and the valves. When a child recovers from rheumatism of the heart, the valves often remain stiffened and out of shape, while the remainder of the heart may go on to complete recovery. So first of all we have to deal with the inflammation of the heart accompanied by fever and all the attending circumstances of an infectious disease. Later on we have to deal with the mechanical difficulties resulting from crippled valves. Sometimes the inflammation remains in the valves for weeks and months, and they gradually become more and more deformed.
While in other parts of this book we are with satisfaction able to reassure, our readers that heart trouble is not as bad as it is often supposed to be, at this paint we find truth compelling us to take the other position, that rheumatic disease of the heart in children and young people is of vastly more importance than it at first appears, and that the utmost patience on the part of the sufferer himself, his guardians, and his medical adviser is the only reasonable assurance of an extended prolongation of life and efficiency.
It is essential that every young person who has inflammatory rheumatism of the heart should rest in bed for several weeks or months, and gradually resume a more active life only when in the judgment of the physician the inflammatory process is no longer progressing.
Unfortunately, the best treatment for rheumatism is by remedies which are disagreeable to take, particularly salicylate of soda, which, when given in sufficient quantities to affect the disease, ordinarily leads to the upsetting of the stomach and to other disagreeable symptoms.
This, with the pain and inflammation of the heart and the length of time during which the person is ill, makes inflammatory rheumatism one of the most serious disorders with which we have to deal. Fortunately, rheumatism is not as frequent as formerly, and not as frequent in this country as in some others. Nevertheless, the number of its victims is considerable.