Papers on medicine and public health 41? 



for the Handicapped, and it is up to us to arrange for 

 the proper employment and for vocational training when 

 needed for our own cases. The Illinois State Employment 

 Bureau has a handicapped department with which we can 

 co-operate at present. A majority of cardiacs can work 

 and they can work steadily if they have the proper job 

 or office. In this line more can be done with children, 

 and the earlier we know that a child has heart disease 

 the better it is for that child. The child can then be 

 trained for a suitable occupation and can become a use- 

 ful, self supporting citizen. For this, we need examina- 

 tion of our school children and examination with the 

 child stripped to the waist. We also need vocational 

 guidance, so that the child, become a man, will not have 

 to seek a job as a laborer on the streets as 88 of the 194 

 patients did. Whether we should have special schools for 

 cardiac children is still a disputed question. They are 

 carrying on some investigations on this subject in New 

 York where there is a difference of opinion. We may 

 have some facts bearing on the subject in Chicago where 

 we have a special class for cardiacs at the Spalding and 

 one other Public School. At present we need a school 

 or shops where the cardiac who has too strenuous a job 

 can learn a new trade by which he can support himself 

 and family without a breakdown. Then, too, we need 

 some way of lightening the mother 's burden in the home. 

 The cardiac mother should not do her heavy work; but 

 who is going to do it for her? There must be a bureau 

 equipped to send some one into the home to relieve 

 the mother of the work she should not do. 



All this of course has to do with the relief of heart 

 disease. In a way it is also prevention, that is, preven- 

 tion of a breakdown of the patient who already has heart 

 disease. So far as the patient goes, he is not concerned 

 about his heart as long as the heart muscle does its work ; 

 and if we handle the cardiac properly we are preventing 

 real invalidism. Further, much can be done in the way 

 of actual prevention if the situation is handled ade- 

 quately. 



Most of the cases of heart disease which occur in youth 

 are due to acute articular rheumatism, and the rest are 



