III. CAUSES 



The question naturally occurs, "Cmi heart disease be pre- 

 vented?" The best way to answer that is to sav that a certain 

 proportion of heart disease can be prevented and still more can 

 be arrested. To prove this statement it will be necessary to give 

 some of the causes of heart disease, and show that had the cause 

 been removed or properly handled the heart would have been in a 

 better condition. 



CLASSIFICATION OF HEART DISEASES OX THE BASIS OF THEIR 



CAUSE 



Infections Excitement 

 Overwork Congenital malformation 



Nervous strain Alcoliol and drugs 



Lues 



The first is probably found more often in children, but many 

 of the adult heart cases can be attributed to this antecedent his- 

 tory. Some of the diseases that children have which are not 

 thought at all serious produce heart lesions.^ According to one 

 report on endocarditis in childhood, rheumatic fever is the main 

 cause of heart trouble. The germ of this disease is stipposed to 

 enter the body thru tonsils, adenoids, or bad teeth. At one time 

 it was thought that a tonsillectomy was the cure-all for chorea, 

 which is all too often accompanied by heart trouble. This has 

 been disproved, as is shown hj a table taken from the pamphlet 

 mentioned above. 



The results^ obtained from the study of a number of children 

 in regard to tonsillectomy and chorea showed that (1) 12 cases 

 had chorea after tonsils were removed: (2) 9 cases had chorea 

 before tonsils were removed; (3) 8 cases had chorea before and 

 after tonsils were removed; (4) 4 cases had chorea after, but not 

 before; (5) 1 case had chorea before, but not after. 



CASE H.H. One little girl has had chorea and heart trouble 

 for some time. When she was first noticed she was a very nervous 

 girl, coming to the Dispensary. Her nervousness was diagnosed 



^ Symposium on Endocarditis in Cliildhood. In Boston Mtdical and Surgical 

 Journal, September 2, 1915. 

 mid. 



(16) 



