THE ETIOLOGY OF RHEUMATIC FEVER
Authors: H P SWIFT
Journal: Annals of Internal Medicine (1949)

Article1 November 1949THE ETIOLOGY OF RHEUMATIC FEVERHOMER F. SWIFT, M.D.HOMER F. SWIFT, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-31-5-715 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAlthough a causative rôle of streptococcal infections with respect to rheumatic fever is fairly widely accepted, the evidence for this opinion seems insufficient for the hypercritical. There are at least three attitudes concerning this question: (1) Acceptance of the thesis and a readiness to apply it practically to public health aspects of the problem; (2) Relative indifference to the information that has been laboriously collected and correlated; (3) Skepticism and reiteration of the statement that the cause of this disease is unknown, or claims that an unidentified virus is the offending agent. It is imprudent to belittle the rôle of...Bibliography1. PRIBRAM A: Der acute Gelenkrheumatismus, 1899, A. Hölder, Wien. Google Scholar2. POYNTONPAINE FJA: Researches on rheumatism, 1913, J. & A. Churchill, London. Google Scholar3. SCHOTTMÜLLER H: Die Artunterscheidung der für den Menschen pathogenen Streptokokken durch Blutagar, München. med. Wchnschr., 1903, l, 849. Google Scholar4. SWIFT HF: The streptococci, Chapter 11, Bacterial and mycotic infections of man, edited by Dubos, 1948, J. B. Lippincott Co., Philadelphia. Google Scholar5. LANCEFIELD RC: Specific relationship of cell composition to biological activity of hemolytic streptococci, Harvey Lectures, 1940-1941, Series xxxvi, 251. Google Scholar6. GRIFFITH F: The serological classification of Streptococcus pyogenes , Jr. Hyg., 1934, xxxiv, 542. Google Scholar7. KUTTNERLENERT AGTF: The occurrence of bacteriostatic properties in the blood of patients after recovery from streptococcal pharyngitis, Jr. Clin. Invest., 1944, xxiii, 151. CrossrefGoogle Scholar8. ROTHBARD S: Bacteriostatic effect of human sera on group A streptococci. I. Type-specific antibodies in sera of patients convalescent from group A streptococcal pharyngitis, Jr. Exper. Med., 1945, lxxxii, 93. CrossrefGoogle Scholar9. LANCEFIELDSWIFT RCHF: Unpublished observations. Google Scholar10. TODD EW: Antigenic streptococcal hemolysin, Jr. Exper. Med., 1932, lv, 267. CrossrefGoogle Scholar11. TODD EW: Antihaemolysin titres in haemolytic streptococcal infections and their significance in rheumatic fever, Brit. Jr. Exper. Path., 1932, xiii, 248. Google Scholar12. TILLETTGARNER WSRL: The fibrinolytic activity of hemolytic streptococci, Jr. Exper. Med., 1933, lviii, 485. CrossrefGoogle Scholar13. CHRISTENSEN LR: Streptococcal fibrinolysis: A proteolytic reaction due to a serum enzyme activated by streptococcal fibrinolysin, Jr. Gen. Physiol., 1945, xxviii, 363. CrossrefGoogle Scholar14. KAPLAN MH in collaboration with the Commission on Acute Respiratory Diseases: Studies of streptococcal fibrinolysis. III. A quantitative method for the estimation of serum antifibrinolysin, Jr. Clin. Invest., 1946, xxv, 347. CrossrefGoogle Scholar15. MEYER K: The biological significance of hyaluronic acid and hyaluronidase, Physiol. Rev., 1947, xxvii, 335. CrossrefGoogle Scholar16. SEASTONE CV: Virulence of group C hemolytic streptococci of animal origin, Jr. Exper. Med., 1939, lxx, 361. CrossrefGoogle Scholar17. HIRST GK: The effect of a polysaccharide-splitting enzyme on streptococcal infection, Jr. Exper. Med., 1941, lxxiii, 493. CrossrefGoogle Scholar18. ROTHBARD S: Protective effect of hyaluronidase and type-specific anti-M serum on experimental group A streptococcus infections in mice, Jr. Exper. Med., 1948, lxxxviii, 325. CrossrefGoogle Scholar19. DURAN-REYNALS F: Tissue permeability and the spreading factors in infection, Bact. Rev., 1942, vi, 197. CrossrefGoogle Scholar20. CROWLEY N: Hyaluronidase production by haemolytic streptococci of human origin, Jr. Path. and Bact., 1944, lvi, 27. CrossrefGoogle Scholar21. PIKE RA: Streptococcal hyaluronic acid and hyaluronidase. I. Hyaluronidase activity of noncapsulated group A streptococci, Jr. Infect. Dis., 1948, lxxxiii, 1. CrossrefGoogle Scholar22. PIKE RA: Streptococcal hyaluronic acid and hyaluronidase. II. Production and subsequent destruction of hyaluronic acid by certain strains of group A streptococci, Jr. Infect. Dis., 1948, lxxxiii, 13. Google Scholar23. QUINN RW: The antihyaluronidase content of human blood serum, Jr. Immunol., 1949, lxii, 185. Google Scholar24. HARRISHARRIS TNS: Studies in the relation of the hemolytic streptococcus to rheumatic fever. V. Streptococcal anti-hyaluronidase (mucin-clot-prevention) titers in the sera of patients with rheumatic fever, streptococcal infection, and others, Am. Jr. Med. Sci., 1949, ccxvii, 174. CrossrefGoogle Scholar25. ELLIOTT SD: A proteolytic enzyme produced by group A streptococci with special reference to its effect on the type-specific M antigen, Jr. Exper. Med., 1945, lxxxi, 573. CrossrefGoogle Scholar26. MCCARTY M: The occurrence of nucleases in culture filtrates of group A hemolytic streptococci, Jr. Exper. Med., 1948, lxxxviii, 181. Personal communication about antibody formation by patients. CrossrefGoogle Scholar27. WATSON RF: Personal communication. Google Scholar28. HERBERTTODD DEW: The oxygen-stable haemolysin of group A haemolytic streptococci (streptolysin S), Brit. Jr. Exper. Path., 1944, xxv, 242. Google Scholar29. BERNHEIMERRODBART AWM: The effect of nucleic acids and of carbohydrates on the formation of streptolysin, Jr. Exper. Med., 1948, lxxxviii, 149. CrossrefGoogle Scholar30. COBURN AH: The factor of infection in the rheumatic state, 1931, Williams and Wilkins Co., Baltimore. Google Scholar31. SHELDON W: On acute rheumatism following tonsillitis, Lancet, 1931, i, 1337. CrossrefGoogle Scholar32. SCHLESINGER B: The relationship of throat infection to acute rheumatism in childhood, Arch. Dis. Child., 1930, v, 411. CrossrefGoogle Scholar33. GRIFFITH F: Types of haemolytic streptococci in relation to scarlet fever, Jr. Hyg., 1926, xxv, 385. Google Scholar34. GLOVERGRIFFITH JAF: Acute tonsillitis and some of its sequels; epidemiological and bacteriological observations, Brit. Med. Jr., 1931, ii, 521. CrossrefGoogle Scholar35. KUTTNERKRUMWIEDE AGE: Observations on the effect of streptococcal upper respiratory infections on rheumatic children—a three-year-old study, Jr. Clin. Invest., 1941, xx, 273. CrossrefGoogle Scholar36. ANDERSONKUNKELMCCARTY HCHGM: Quantitative antistreptokinase studies in patients infected with group A hemolytic streptococci: a comparison with serum antistreptolysin and gamma globulin levels with special reference to the occurrence of rheumatic fever, Jr. Clin. Invest., 1948, xxvii, 425. CrossrefGoogle Scholar37. FRIOUWENNER GJHA: On the occurrence in human serum of an inhibitory substance to hyaluronidase produced by a strain of hemolytic streptococcus, Jr. Infect. Dis., 1947, lxxx, 185. CrossrefGoogle Scholar38. QUINN RW: Antihyaluronidase studies of sera from patients with rheumatic fever, streptococcal infections, and miscellaneous non-streptococcal diseases, Jr. Clin. Invest., 1948, xxvii, 471. CrossrefGoogle Scholar39. HARRISHARRISNAGLE TNSRL: Studies in the relation of the hemolytic streptococcus to rheumatic fever. VI. Comparison of streptococcal antihyaluronidase with antibodies to other streptococcal antigens in the serum of patients with rheumatic fever and acute streptococcal infection: mucin clot prevention test, Pediatrics, 1949, iii, 482. Google Scholar40. GUERRA F: Hyaluronidase inhibition by sodium salicylate in rheumatic fever, Science, 1946, ciii, 686. CrossrefGoogle Scholar41. HARRISFRIEDMAN TNS: Studies in the relation of hemolytic streptococci to rheumatic fever. IV. Effect of streptococcal spreading factor in rheumatic patients and others, Am. Jr. Dis. Child., 1949, lxxvii, 561. Google Scholar42. TODDCOBURNHILL EWAFAB: Antistreptolysin S titres in rheumatic fever, Lancet, 1939, ii, 1213. CrossrefGoogle Scholar43. ROTHBARDWATSONSWIFTWILSON SRFHFAT: Bacteriologic and immunologic studies on patients with hemolytic streptococcic infections as related to rheumatic fever, Arch. Int. Med., 1948, lxxxii, 229. CrossrefGoogle Scholar44. SWIFTHODGE HFBE: Type-specific anti-M precipitins in rheumatic and non-rheumatic patients with hemolytic streptococcal infections, Proc. Soc. Exper. Biol. and Med., 1936, xxxiv, 849. CrossrefGoogle Scholar45. COBURN AF: Observations on the mechanism of rheumatic fever, Lancet, 1936, ii, 1025. CrossrefGoogle Scholar46. WATSONROTHBARDSWIFT RFSHF: Type-specific protection and immunity following intranasal inoculation of monkeys with group A hemolytic streptococci, Jr. Exper. Med., 1946, lxxxiv, 127. CrossrefGoogle Scholar47. ALLISONBROWN VDWA: Reinfection as a cause of complications and relapses in scarlet fever wards, Jr. Hyg., 1937, xxxvii, 153. CrossrefGoogle Scholar48. MASSELLDOWJONES BFJWTD: Orally administered penicillin in patients with rheumatic fever, Jr. Am. Med. Assoc., 1948, cxxxviii, 1030. CrossrefGoogle Scholar49. POWERSBOISVERT GFPL: Age as a factor in streptococcosis, Jr. Pediat., 1944, xxv, 481. CrossrefGoogle Scholar50. ANDREWESDERICKSWIFT CHCLHF: The skin response of rabbits to non-hemolytic streptococci. I. Description of a secondary reaction occurring locally after intradermal inoculation, Jr. Exper. Med., 1926, xliv, 35. CrossrefGoogle Scholar51. DERICKSWIFT CLHF: Reactions of rabbits to non-hemolytic streptococci. I. General tuberculin-like hypersensitiveness, allergy, or hyperergy following the secondary reaction, Jr. Exper. Med., 1929, xlix, 615. CrossrefGoogle Scholar52. SWIFTDERICK HFCL: Reactions of rabbits to non-hemolytic streptococci. II. Skin reactions in intravenously immunized animals, Jr. Exper. Med., 1929, xlix, 883. CrossrefGoogle Scholar53. BÖHMIGSWIFT RHF: Comparative histologic reactions in cutaneous lesions induced by streptococci in rabbits previously inoculated intracutaneously or intravenously, Arch. Path., 1933, xv, 611. Google Scholar54. BÖHMIG R: Über homologe und heterologe Testinfektionen mit Streptokokken in verchiedenen Stadien der Immunität, Ztschr. f. Hyg. u. Infektionskrank., 1933, cxv, 406. CrossrefGoogle Scholar55. SWIFTHARTMAN HFTL: Unpublished observations. Google Scholar56. MURPHYSWIFT GEHF: Induction of cardiac lesions, closely resembling those of rheumatic fever, in rabbits following repeated skin infections with group A streptococci, Jr. Exper. Med., 1949, lxxxix, 687. CrossrefGoogle Scholar57. KLINGE F: Der Rheumatismus, pathologisch-anatomische und experimentelle-pathologische Tatsachen Auswerten für das Ärtzliche Rheumatismus, Ergb. allg. Path. u. path. Anat., 1933, xxvii, J. V. Bergmann, München. Google Scholar58. RICH AR: Hypersensitivity in disease, with especial reference to periarteritis nodosa, rheumatic fever, disseminated lupus erythematosus and rheumatoid arthritis, The Harvey Lectures, 1946-1947, Series xlii, 106. Google Scholar59. EHRICHSEIFTERFORMAN WEJC: Experimental serum disease: a pathogenic study, Jr. Exper. Med., 1949, lxxxix, 23. CrossrefGoogle Scholar60. ASCHOFF L: Über den Begriff der allergischen Krankheiten, Med. Klin., 1935, xxxi, 1. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, N. Y.*Kober Lecture, delivered at Georgetown University Medical Center, Washington, D. C., March 28, 1949.Delivered in part before the Thirtieth Annual Session of the American College of Physicians, New York, N. Y., April 1, 1949.From the Hospital of The Rockefeller Institute for Medical Research, New York City. 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SMYTH, M.D.The etiological role of streptococcus toxin-antitoxin systems in the experimental production of arterial sensitizationNature of collagen diseasesZur Epidemiologie und �tiologie des akuten RheumatismusRelationship of bone marrow plasmacytosis to the changes in serum gamma globulin in rheumatic fever 1 November 1949Volume 31, Issue 5Page: 715-738KeywordsEtiologyHealth information technologyPrevention, policy, and public healthReactive arthritisRheumatic feverStreptococcal infections ePublished: 1 December 2008 Issue Published: 1 November 1949 Copyright & PermissionsCopyright, 1949, by The American College of PhysiciansPDF downloadLoading ...