The cause of rheumatic fever is still unknown. The disease attacks particularly children of the poorer economic classes, and it is therefore not surprising that it has been etiologically connected with three other disorders which prevail in the same group, viz., tuberculosis, streptococcic infections and vitamin deficiency diseases. No one has as yet succeeded, however, in demonstrating a direct link between these diseases and rheumatic fever.
The importance of the hemolytic streptococcus in producing rheumatic fever has been advanced by Coburn and Pauli,1 who stated the belief that the reaction of the patient to certain well defined strains of hemolytic streptococci is the underlying cause of rheumatic fever. However, the reports of Wheeler and her associates,2 whose material must have been drawn from the same vicinity as the material of Coburn and Pauli, contradicted this view. Until the results of investigators are in accord, the entire question must
FRIEDMAN M, KLEIN R, ROSENBLUM P. EFFECTS OF SERUM TRANSFER IN PATIENTS WITH RHEUMATIC FEVER. Am J Dis Child. 1938;56(6):1304-1311. doi:10.1001/archpedi.1938.01980180118010