During recent years, numerous surveys have been made on the relationship of the tonsils to rheumatic manifestations. The interpretation of these results has not been uniform, but most authorities concede that the tonsils bear a certain relation to rheumatism and to rheumatic endocarditis. A more accurate understanding of this relationship is desirable.
In this survey, 439 children who had acute rheumatism were studied, and a special effort was made to determine the relationship of the rheumatic attacks to the presence or absence of the tonsils. The term "acute rheumatism" is used in order to include the cases of children who did not have the classic attacks of rheumatic fever, but in whom there had been definite involvement of the joints and muscles. Two hundred and forty-one of the children studied had characteristic attacks of rheumatic fever, 138 had acute pains in the joints but no redness or swelling, and 60