THE NATURAL HISTORY of any chronic disease is always a subject of interest and importance to the clinician. Unusual cases, therefore, deserve recording when they represent or illustrate the exception that also tends to alter or broaden the rule.1
Report of Cases
The two cases reported here illustrate the course that rheumatic heart disease may take in the aged.
A 46-year-old single, white woman was first examined in 1933 for questionable anemia. The family history indicated that her father died of a stroke at age 70 and her mother died of stomach ulcers at age 69. Two sisters were living and well, although one had rheumatic fever and nephritis at age 43 following severe tonsillitis. The sister's blood pressure was also elevated. There were no brothers.The patient gave no history of scarlet fever, rheumatic fever, or chorea but there was a history of recurrent tonsillitis prior