Cortisone and Corticotropin in Rheumatic Fever and Juvenile Rheumatoid Arthritis.

To evaluate properly the effects of cortisone on rheumatic fever, it is necessary to divide the many different manifestations of the disease into two categories (table 1). In the first group should be included the systemic or nonspecific clinical and laboratory features of the disease. The second group would comprise manifestations characteristic of rheumatic fever. NONSPECIFIC CHARACTERISTICS OF RHEUMATIC FEVER The nonspecific manifestations of rheumatic fever are increased temperature and heart rate, "toxicity," loss of appetite, anemia, elevated erythrocyte sedimentation rate, increased concentration of serum fibrinogen and globulin levels, and the appearance of C-reactive protein (CRP) in the blood. All these nonspecific changes return or tend to return to normal with the administration of cortisone. Most dramatic of these is the prompt subsidence of fever and the toxicity seen in severe cases of rheumatic fever. Another effect is reduction in the sedimentation rate. Of the various constituents of the blood