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Advances in rheumatic fever, 1940-1961. Epidemiological and clinical studies of patients during the first five decades of life.

Alvan R. Feinstein, MD
JAMA. 1963;183(13):1117. doi:10.1001/jama.1963.03700130085023.
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Dr. May Wilson, a prominent and productive investigator of rheumatic fever for almost 50 years, has written this monograph as "a supplement, not a revision," of her earlier book published 20 years ago. Among the new data are long-term observations of survival and cardiac changes, studies of age susceptibility, serum protein constituents, and ecologic and genetic factors in rheumatic fever. Her current diagnostic and therapeutic techniques are completely described.

Dr. Wilson does not accept the validity of certain recent conceptual doctrines. Most other workers now believe that acute rheumatic fever is always part of the spectrum of complications triggered by Group A streptococcal infections in susceptible hosts and that continuous antimicrobial prophylaxis should be given indefinitely to all rheumatic patients. Dr. Wilson believes the initiating role of the streptococcus is "not as yet based on conclusive evidence," and prefers to treat streptococcal infections as they are discovered, since she regards


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