Massell has suggested that treatment with corticotropin (ACTH) or cortisone effectively suppresses subcutaneous nodules due to rheumatic fever.1 Whereas such nodules may persist or progress under salicylate therapy, they disappeared in 29 patients "adequately" treated with hormones. Less satisfactory therapeutic results were cited in the joint report on rheumatic fever, a survey of the results in the United Kingdom and the United States.2 Since subcutaneous nodules are more frequently observed in children than in adults, the following report is cited in detail because of unusual features of age of onset, persistence despite therapy, and eventual recovery.
Report of Case
A 40-year-old machinist entered the Seattle Veterans' Administration Hospital June 7, 1954, with the complaint of painful joints of five weeks' duration. Three months and again one month before admission the patient noted soreness of his throat, lasting several days. Five weeks before admission he experienced pain in his