The inter-relations of rheumatism, heart disease, and chorea, have been made the subject of a very interesting investigation by Walton and Vickery.1 These gentlemen approached the subject with a priori feeling that the relations generally supposed to exist between these several conditions, were probably incorrect, but their results have confirmed, substantially, the current opinion.
Their study is based upon an analysis of 76 cases of chorea, which they saw together, and which have been studied with unusual care. They excluded chorea apparently due to hysteria, and habit chorea, as well as chorea due to gross organic disease of the brain. Careful distinction was made between functional and organic heart disease, and the diagnosis of cardiac lesion was not based upon a single sign, but upon the entire group of objective symptoms— "the size of the heart, the presence or absence of a thrill, the locations of the murmurs heard,
RHEUMATISM, HEART DISEASE, AND CHOREA.. JAMA. 1892;XVIII(19):595–596. doi:10.1001/jama.1892.02411230025014