This note begins with analogy and ends in exhortation. The analogy consists in a fundamental likeness between the demographic aspects of what I will venture to call subclinical infections of the heart, and incipient tuberculosis of the lungs.
No broad scheme for the prophylaxis of tuberculosis was possible until hygienists grasped the fact that tuberculous infection is wellnigh universal. Thereupon the practical procedure became one largely of devising means to prevent a harmless anatomic infection from developing into a dangerous clinical disease. Accordingly, whatever the physical condition may be which the clinician is called on to consider, he has in mind tuberculosis. Particularly in the case of children does he search out in tuberculosis an explanation of morbid symptoms. The result is the control of established tuberculosis.
Just as civilized mankind harbors almost constantly a more or less latent tuberculosis, so infective disease of the heart, provoking no classical symptoms,
SEWALL H. ONE ROAD TO THE CONTROL OF HEART DISEASE. JAMA. 1917;LXVIII(22):1604–1609. doi:10.1001/jama.1917.04270060014005
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