By John R. Paul, M.D., and other contributors, for the American Heart Association. New York: Metropolitan Life Insurance Company, 1943.
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The author looks on rheumatic fever as a specific disease, though he admits that there is not uniformity of opinion in so regarding it. The argument centers on the relationship of hemolytic streptococcic infections to rheumatic fever. There is no doubt of the close relationship between the two. Nevertheless it has not been proved that hemolytic streptococci are the only infectious agents in rheumatic fever, and until this question has been settled it is wise to consider it a distinct disease.
Rheumatic fever has been poorly defined and has been neglected in compilations of vital statistics. Only a rough estimate of its incidence and importance can be obtained. However, in the northern half of the country it probably ranks next to tuberculosis and syphilis among the chronic infections.
The period of greatest susceptibility is that of midchildhood, which is due in part perhaps to the fact that there is more
The Epidemiology of Rheumatic Fever and Some of Its Public Health Aspects.. Arch Intern Med (Chic). 1943;72(4):563. doi:10.1001/archinte.1943.00210100136012