PEDIATRICS Vol. 1 No. 3 March 1948, pp. 400-415
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Round Table Discussion

RHEUMATIC INFECTION IN CHILDREN

ARILD E. HANSEN M.D. and GLADYS J. FASHENA M.D.

Chairman Hansen: That we are here today bespeaks our interest in the problem of rheumatic fever. Undoubtedly some have come in hopes of finding new clues to a better understanding of a difficult problem, in spite of quite intimate knowledge of the field. Others may feel they have been pressed with variable agitations from many sources, hence desire to become more familiar with general features as well as details. From the viewpoint of the persons asked to conduct this Round Table Discussion, the same features apply; namely, the desire to gain exact information, yet help if possible in the clarification of points which are becoming generally accepted. The subject is broad, varied, indefinite and controversial at times even to the point of provoking emotional responses. Its importance is undisputed, the frequently cited comparatives and invectives in vogue may be mentioned as evidence:

"One of the chief causes of death in the school age child—responsible for more deaths in this age group in almost any year than the combined deaths from ordinary childhood diseases, e.g. diphtheria, poliomyelitis, scarlet fever, measles, mumps, with meningococcic meningitis thrown in— responsible for seven times the number of deaths as poliomyelitis in this age group—significantly more deaths than from all forms of tuberculosis—chief cause of death from heart disease in the young adult—and one of the chief causes of disability in children and youth—producing 'cripples who do not limp' also 'cripples who cannot even walk.' "

Textbook knowledge, perusal of current literature and personal consultation coupled with practical experiences allow one to comprehend the problem of rheumatic fever in childhood almost as well as the "expert".