There has been a decided advance in pediatrics in the last twenty-five years. Many of the diseases of infancy and childhood occur with less frequency and diminished virulence. This progress has been due to many factors, among them the development of preventive medicine and hygiene, and the important results of laboratory investigations and methods. What influence, if any, have these factors had on the clinical course of rheumatism? What influence, more particularly, has the recent increase in tonsillectomies had on the recurrence of rheumatic manifestations? These considerations have suggested a comparison between the classical description of rheumatism in children given by Cheadle1about thirty-five years ago, and rheumatism as it is seen today both in England and in this country. What are the manifestations of rheumatism today and what are their relative incidence? These are some of the questions we have attempted to answer in this study. Our material