[The medico-social problem of rheumatic valve disease in Sicily]

The incidence of rheumatism and rheumatic valvulopathy in Sicily is assessed and the sites most commonly involved in the first and second attacks described. The medical aspects of te question are examined from several points of view: prophylaxis of sites, medical treatment personal and ambient hygiene, gradual defectiveness of the pump, associated diseases, etc. The concept of invalidity is viewed in terms of direct and associated anatomical damage and frank and potential invalidity (absolute or relative), the weight or assistance attributable to the family and the incidence of the local social environment in the question of finding work, etc. The basic criteria for surgery are noted. Care must be taken to preserve the few remaining structures. Mortality is still high and the incidence of heart disease is higher among rheumatic Sicilian children. Not enough is known about overcrowding, the schools attended by the poor, and the higher incidence in low-income classes. Failure to affront some of these features, determined as much by action (or its postponement) by government as by income, results in meaningless medicine, divorced from social reform and true the scientific spirit, a cover for special interests and a demonstration of profit factors wherein the commercialising relationship is increasingly evident.