Prophylaxis depends on etiology and pathology; while general management must be co-ordinated with specific treatment, and modified to meet any complications that may arise. It is impossible, therefore, to discuss these two topics without some reference to the subjects that have been assigned to other speakers. Such reference will, however, be chiefly in the way of brief allusion, taking for granted the facts that have been, or will be, elaborated by my colleagues in the symposium.
The prophylaxis of acute articular rheumatism has four phases. These refer, respectively, to (1) the initial attack; (2) the complications, especially the cardiac affections; (3) relapses; (4) recurrences. At present this prophylaxis is, in all its phases, largely empirical, because pathology and etiology have not yet given us the necessary exact bases for an exact scientific preventive régime.We are all agreed that the condition called acute articular rheumatism is a special