Differences of opinion are to be expected regarding the treatment of rheumatic fever and prevention of recurrences until additional knowledge explains the protean manifestations of the disease. One has to admit that no treatment specific for rheumatic fever is known.
Many types and various phases of the disease have been described.1 In children the chief manifestation of acute rheumatic fever, regardless of clinical type, is carditis. As is well known, an outstanding characteristic of the disease is its tendency to recur. For the purpose of the present discussion I shall divide the disease into five phases: the phase of invasion of the inciting agent, the phase of latency between the invasion and the development of symptoms and signs of the disease, the phase of acute activity, the prolonged phase of subacute activity and the phase of inactivity.
A child with rheumatic fever may come under observation for treatment in