Why Did The Original Jones Criteria Not Emphasize Streptococcal Infection

Abstract T. Duckett Jones’ 1944 Jones Criteria for the diagnosis of Acute Rheumatic Fever did not require preceding group A streptococcal infection despite widely accepted strong evidence by Alvin Coburn and others. We reviewed relevant literature, previously unknown 1943 T. D. Jones correspondence, and Coburn's autobiography and archival material. New information concerning the fraught Jones-Coburn personal relationship very likely explains Jones’ unwillingness to accept Coburn's 1931 discovery of the crucial streptococcal link. Shortly after Jones’ 1954 death, the Jones Criteria were revised to emphasize the essential streptococcal role. Despite clear evidence in his correspondence that Jones fully understood the strength of the group A Streptococcal-Rheumatic Fever link before 1944, he failed to acknowledge this in the original Jones Criteria and denied it to his death in 1954. This episode demonstrates how interpersonal relationships have the potential to interfere with acceptance of new medical data.