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The Manner of Onset in Acute Rheumatic Fever As Seen in New York City

Ann Intern Med. 1932;6(6):717-723. doi:10.7326/0003-4819-6-6-717
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It is universally recognized that rheumatic fever differs materially in its rate of occurrence, in its clinical picture and even in its complications in various parts of the world. Even with very slight variance in geographical distribution, the disease is strikingly modified in many of its most essential respects. Longcope has several times called attention to the fact that the disease as it appears at even so short a distance from New York as Baltimore is very different both in occurrence and in symptomatology. Rare in the tropics, and even in the subtropics, the disease is hardly recognizable to the


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