Rheumatic Fever in America and Britain is the first book to examine comprehensively a disease that has been a moving target for physicians and health care workers. A disease of skin, brain, heart, connective tissue, blood, tonsils, and joints bound to a member of the streptococcus family of bacteria, this illness has practically disappeared from the present-day scene. Yet in 1940 more than one million Americans suffered from the heart disease that followed the ravages of rheumatic fever. It struck nearly 2 percent of all school-aged children, filling hospitals, convalescent homes, and special schools.
Rheumatic fever rose in prevalence throughout the nineteenth century, reaching its peak in that century's last decades, and then steadily declined-both in occurrence and severity-throughout the twentieth century. In the nineteenth century, acute rheumatic fever was largely a disease of children and young adults. Another remarkable epidemiological change occurred during the twentieth century; rheumatic fever shifted its character, became milder, and in doing so allowed its victims to live longer, if disabled lives. As this disease so altered, adults increasingly became its victims.
Dr. Peter C. English explores both the shifting biological nature of this disease and the experiences of physicians and patients who fought its ravages. Using insights from biology, epidemiology, and social history, Dr. English-both a physician and medical historian-is uniquely suited to unravel this disease's epidemiological and cultural complexities.