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January 6, 1945

Current Comment

JAMA. 1945;127(1):30. doi:10.1001/jama.1945.02860010032013

THE NATURAL HISTORY OF RHEUMATIC FEVER  An unusual opportunity to study the natural history of rheumatic fever was provided by the stationing of a large body of British troops and their hospital in a remote desert isolated from outside contacts for a period of nearly a year. Copeman,1 reporting on this subject in the Annals of the Rheumatic Diseases (a journal recently taken over by the British Medical Association for quarterly publication), says that the possibility of an external source of infection being the cause of the 32 patients' suffering from first attacks of rheumatic fever and of the 10 who had had previous attacks was remote. Almost every case fell into one of two groups: 1. A nonrheumatic infection whose role appeared to be to lower the patient's general resistance. This possibility allowed of a successful attack by the hypothetical specific organisms. These "preceding infections" were not always