Evening star. [volume] (Washington, D.C.) 1854-1972, 1927-03-01
Valvular Leakage PNventable.

Nine-tenths of the heart disease
| physicians find in persons under
middle age Is valvular leakage result
ing from an attack Of rheumatic
fever. inflammatory rheumatism. acute
| multiple infectious arthritis. LAS !
have 50 often and so dogmatically de-
clared. there is no such disease as
rheumatism" I must explain here
that the consensus Of medical opinion
at present Is that this rheumatic
fever" is probably due to specific
germ, 1t Is certainly infectious. and
until the specific germ Is determined
we have no better name for the ill
ness. 1t Is not the same as the va
roous chronic or long-continued joint
troubles which commonly masquerade
as rheumatic" There is no danger,
no tendency toward heart valve in
| volvement In the chronic joint
troubles, such as characteriZes rheu-
matte fever)
rheumatic fever the illness is appar-
entity mild and the patient, usually a
young child. develops no marked in
fiammation Of the joints. but just
some slight fever. perhaps associated
with sore throat and vague aches
or pains which are too often dubbed
growing pains" Such cases may not
be recognized as Of any seriousness.
yet there is nevertheless risk OF
damage to the valves Of the heart.
In rather more than half Of all cases
OF rheumatic fever. including these
unrecogniZed cases, the lining of the
heart becomes involved. and usually,
though not invariably, this means that
some permanent damage of the heart
valves will occur.
1t Is in the mild, masked or un-
recognized case of rheumatic fever
that many an otherwise inexplicable
valvular lesion, discovered later in life.
has it's origin. The primary illness is
perhaps mistaken for tonsilitis or sim
pie sOre@throat, or even for q general
cold" Some health authorities still
encourage the popular belief in a
vague, underlined entity called "com.
mon cold" No health authority ven.
lures to define this common cold"
Defining 1t Is something like trying
to describe ectoplasm.
One eminent physician. noted for
his power Of description, has attempted
to describe ectoplasm, yet IL / see or
feel anything in a dim religious light
/ shall not kid myself It Is ect0plaSm
until all other possible explanations
have been exhausted. I feel that way
about the common cold" too. You
may have one if you insist. but until
the denalement Of your little plot ]
shall endeaver to keep out of your
range.
The assertion that nine-tenths of all
heart disease In persons under middle
age is valvular disease resulting from
rheumatic fever. and the assertion
that the lining Of the heart becomes
involved in more than half Of all cases
Of rheumatic fever. are based on solid
statistics. Now I must add mere
estimate having no statistics to study,
Of the proportion Of cases of rheu-
matte fever with heart valve damage
which are not recognized or diagnosed
at the time of the primary illness.
| estimate that one case in every FIVE
cases of valvular disease belongs in
this category.
Even were the primary illness ua-
erringly recognized as rheumatic fever
and the patient properly cared for
accordingly, we cannot say that the
heart complication is always prevent