RHEUMATIC FEVER

THERE is no specific treatment for rheumatic fever. Much can be done, however, to help the patient. The exact pathogenesis of rheumatic fever remains unknown, but there is no longer serious doubt that it develops as a complication of infection with Group A streptococci. Highly effective antibiotic therapy has made control of streptococcal infection in rheumatic subjects feasible. Furthermore, the availability of nonspecific but highly potent antiinflammatory agents such as salicylates and the adrenal cortical hormones affords the means of controlling the toxic manifestations of the disease in most cases. In my opinion the proper administration of these agents is a valuable aid in the management of the acute stage of the disease even though there is no definite evidence that the ultimate degree of cardiac damage sustained can be reduced. This discussion makes no attempt to review the voluminous literature on the treatment of rheumatic fever. It presents, rather,