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Rheumatic Fever Rheumatic Fever and Streptococcal Infection: Unraveling the Mysteries of a Dread Disease

JAMA. 1998;280(21):1872. doi:10.1001/jama.280.21.1872.
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Benedict Massell graduated from Harvard Medical School in 1931 and began a 67-year career as a clinician and investigator in the area of rheumatic fever. With Rheumatic Fever and Streptococcal Infection, this highly respected, venerable physician contributes a remarkable scholarly review of the history and current status of this intriguing and enigmatic disease.

What emerges from Dr Massell's carefully documented material is a historical medical mystery story with documentation of every major (and minor) contribution leading to the current understanding of rheumatic fever. Contributors weave through this fascinating account from Hippocrates to 20th century investigators, not the least of whom is Dr Massell himself. Familiar names appear as the rheumatic fever and streptococcal drama unfolds, sometimes surprisingly outside the usual cast of characters associated with rheumatic fever research. For example, 9 years before Jenner was to discover that smallpox could be prevented by vaccination, Dr Massell relates that "Edward Jenner reported at a meeting of the Gloucestershire Medical Society at the Fleece Inn in Rodbourgh his clinical pathological observations on heart disease associated with acute rheumatism. Jenner did not receive credit for these observations because his oration was never published and the manuscript was lost. However, there is documentation of his lecture, including a letter that Dr Jenner wrote in 1805 to Dr Caleb Hillar." The forgoing illustrates the depth of Massell's remarkable research into the origins of our present understanding of rheumatic fever and streptococcal infection.


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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