Thompson: The Cardiac Case 



23 



cannot be made to see that rest in bed is necessary, in spite of the 

 fact that the child is neither suffering pain nor is ''sick at the 

 stomach'-, an attempt is made to secure the very necessary rest, 

 fresh air, and wholesome food elsewhere. 



As soon as the child's heart is able to compensate to even a 

 slight degree, exercise is allowed under strict supervision. When 

 complete compensation is established the child is allowed to 

 return to normal life, but always must be watched. This is neces- 

 sary, for sometimes even a few minutes of overwork or too hard 

 play will cause a break in compensation, and the entire process 

 of rest and after-care must be repeated. In this Department's 

 study of the cardiac case, the need for some home in which the 

 children could be cared for during the period of convalescence 

 after leaving the hospital has been felt. 



CASE H. In one case, a little girl about ten years old with 

 a complication of chorea and heart trouble, the mother was told 

 to keep the child in bed ; give her plenty of good, nourishing food ; 

 allow her to sleep in a room by herself with plenty of fresh air. 

 Were these directions followed? There was no apparent reason 

 why they should not have been. The mother seemed devoted to 

 her children. She could understand what was said to her, and 

 was so situated that the directions could have been carried out 

 without any unbearable hardship. A visitor who followed the 

 case called one day soon after treatment was started. Before 

 she reached the home she met her patient on the sidewalk on 

 roller skates. She talked to the mother in the home and learned 

 that the child was sleeping in the family sitting-room by the 

 stove with no outside air in the room. This arrangement forced 

 the child to stay up until all the family had retired. She was 

 then in the habit of reading a long time after going to bed. To 

 some this may seem to be a personal matter, but when it is known 

 that the child was staying out of school because of this cardiac 

 and chorea trouble, it takes on a more serious appearance. Could 

 convalescent care have been provided out of the home, the prob- 

 lem would not have been so difficult. 



CASE W.B. Another patient, a little boy of about the same 

 age, was brought to the dispensary. His heart and nerves were 

 in a very bad condition, but he did not have chorea. The doctor 

 advised as to treatment and referred him to the Department for 

 following. His aunt, with whom he lived, was told how to care 



