THE USE OF PENICILLIN IN RHEUMATIC FEVER

Although the etiology of rheumatic fever is not fully understood, current data indicate that attacks of this disease are generally preceded by infections with group A hemolytic streptococci. The sequence of events is so regular that one is justified in advancing the hypothesis that the streptococcic infection induces rheumatic fever. Whether group A streptococci are the only infectious agents responsible for rheumatic fever or whether they merely activate some other specific micro-organism or virus and possibly act in concert with it to produce the disease has not been determined. The temporal relationship between the hemolytic streptococcic infection and the attack of rheumatic fever is generally not immediate. In fact, the usual sequence of events is streptococcic infection, quiescent period, rheumatic fever. These phases have been designated as I, II and III respectively. It has been shown that if the initiating or inducing streptococcic infection, phase I, is prevented in susceptible