ETIOLOGY AND PATHOGENESIS OF RHEUMATIC FEVER

Abstract

Rheumatic fever is the cause of much disability and of many deaths resulting from the acute process and from the chronic heart disease which so frequently follows. The investigation of preventive and therapeutic measures for the control of this serious disease has been greatly hampered by the failure of many studies to establish satisfactorily its etiology and pathogenesis. During the past twenty years it has become increasingly apparent that infection by hemolytic streptococci is in some way related to the development of the rheumatic state. The evidence on which this fact has been based has been of an indirect nature and may be summarized as follows: 1. Rheumatic fever has been observed to follow known hemolytic streptococcus infections, particularly of the respiratory tract. In these circumstances it has been noted that the initial acute illness is usually followed by a latent or quiescent period, which terminates in the more or