The Birmingham age-herald., 1924-02-25
Rheumatic Fever
By H. ADDINGTON BRUCE

More and more it is borne in upon ths medical profession that so-called rheumatic fever is, in its possible after-effects, one oi the direst of diseases. Again and again i, has as sequel weakening of the heart, with the result of an untimely death in innumer able cases.
 And hitherto it's prevention has 'baffled medical science.
 Its immediate cause, it is well established is streptococcus infection. But streptococci like the germs of tuberculosis attack yir tually everybody. How to determine why they develop rheumatic fever in some per sons, and not in others, that is the problem Now comes an English physician, Dr Llewellyn J. Llewellyn, with some sugges tions (contributed to American Medicine) which may help toward the solution of the problem that rheumatic fever so poignantly presents. In no uncertain language Dr. Llewellyr harks back to the old theory of rheumatic diathesis, or inherited predisposition to rheu matic fever. But he is more explicit than the ancients with reference to the character of the inheritance. He is not content with generalizations. He specifics.
 For one thing, he specifics that the pre- disposed by inheritance have certain physi cal and psychic traits:
 'They are usually fair-haired, of delicat.
 
 and readily fatigued-the homeopathic ol hypertOnic child"
 | That is, they are uncommouly sensitive 1 the tender-minded rather than the tough | minded of William James's classification But also. according to Dr. Llewellyn's find ings. the predisposed to rheumatic fever hay, some special weaknesses. They are liable tt suffer from such affections as asthma, ec zema, urticaria-Our old friend, the hives and sundry other skin diseases. ' s4sz Asthma, eczema. and the rest are nov known to be frequently due to an intoler ance for various proteins. In some cases | special kind of meat-chicken or turkey, fol example-is positively poisonous. In othel cases, there is an intolerance for peas ol beans, etc. Llewellyn asks:
 "Is it not altogether probable that the dis connected elements of the rheumatic series. when they appear, are but further clinica varieties due to the same underlying cause ?
 Hence as all aid in preventing rheumati fever, he suggests the application of skin tests to determine whether this or that pro tein is poorly tolerated. Naturally, he woul, apply the tests particularly to the fair haired, light-complexioned, and hypersensi | tive.
 Also, bearing in mind the exceptional oc currence of rheumatic fever among the chiI dren of the poor, Dr. Llewellyn stresses tn .upof.ohce' noI merely or leaving this O that food out of the diet according to tn verdict Of the skin tests, but of making sur that the diet is really nourishing.
 He recalls McCarrison's studies of. tn hearts of animals fed on devitaminize, diet, and stresses the weakening conse Quences. Let the diet be inadequate, and, i would seem, the least infection by strepto cocci may have deadly results. For througl mainutrition there may gradually be eftecte, | nrAntQnnQAA 0n -As bility to bacterial proteips.
 In other words, the use of skin-tests an, Ne taking of special dietary precautions an advocated by Llewelyn as contributing to tn prevention of rheumatic fever. Time alon can establish the soundness of his views But the situation is such that they at leas afford hint worth application.