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April 13, 1940


JAMA. 1940;114(15):1477. doi:10.1001/jama.1940.02810150063022

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To the Editor:—  An article of interest and practical importance by Drs. Edward F. Bland and T. Duckett Jones "The Delayed Appearance of Heart Disease After Rheumatic Fever," appeared in The Journal, Oct. 7, 1939.Sir Arthur Newsholme repeatedly expressed the opinion that rheumatic fever does not exist without endocarditis and further stated, as is well known, that clinical recognition of the lesion might be delayed for some time. If my memory serves me, I believe he suggested the name "endocarditis rheumatica" as the most descriptive term for the infection.Many years ago Sansum, a well known English clinician of his period, called attention to reduplication of the first sound as a precursor of mitral stenosis, a sound which might precede the clinical appreciation of a stenotic lesion by many months.Approximately thirty years ago I saw a child who had, as is so common, mild evanescent evidences of arthritis,

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