Interstate medical journal . ears, they become nearly equal, the proportion of 15 to 14. In the nextperiod of eleven to fifteen years, there comes a remarkable change, the BRODERICK: RHEUMATISM IN CHILDREN 755 proportion is suddenly reversed, the girls suffering in the proportion ofnearly 2 to 1. There is a true placental transmisson, e. g., a woman in the lastmonths of pregnancy and suffering from acute articular rheumatism,gives birth to -a child with an acquired heart lesion. Cheadle, to whom we owe much, contended that the greater the heredi-tary factor (rheumatism in both parents) the gre
Interstate medical journal . ears, they become nearly equal, the proportion of 15 to 14. In the nextperiod of eleven to fifteen years, there comes a remarkable change, the BRODERICK: RHEUMATISM IN CHILDREN 755 proportion is suddenly reversed, the girls suffering in the proportion ofnearly 2 to 1. There is a true placental transmisson, e. g., a woman in the lastmonths of pregnancy and suffering from acute articular rheumatism,gives birth to -a child with an acquired heart lesion. Cheadle, to whom we owe much, contended that the greater the heredi-tary factor (rheumatism in both parents) the greater the susceptibilityand the more severe the course. Frequency. Dr. George Still of London has computed that twenty-five per cent, of all medical admissions in the Hospital for Sick Childrenwere for rheumatism, and from fifteen to twenty per cent, of these haveor develop chorea. Symptomatology. (I.) Fleeting pains, definite or indefinite in loca-tion. When assigned to joints there may be no inflammatory reactionof Fig. 3. Vegetations on mural surface and free edges of valve of left , aortic and pulmonary valves normal. (II.) Pain in abdomen, often spasmodic and radiating. No findingsin the abdomen. Still assigns these pains to a catarrhal gastritis. Nonausea or vomiting. (III.) Endo-, peri- or myocarditis in successive stages, or the soli-tary presence of an endocarditis. Embolism may be the first manifesta-tion of an endocarditis. The degree, character and continuous presenceof this murmur offers no criterion for judgment of the degree of defectof the valve segments. I believe with Hochsinger in the nonexistenceof haemic or functional murmurs in children. Any systolic murmur notcardiopulmonary in origin or extracardial in origin, e. g., pressure mur-murs, can be safely concluded as organic and subject to our generalknowledge of interpretation of location. I wish to call attention to the wider prevalence of mitral stenoticmurmurs in rheumatism. I had
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