During and immediately following World War II the opportunity presented itself to observe numerous cases of rheumatic fever in young adults. The present study was undertaken from patients admitted to the Brooke General Hospital over a period of one year. There were four hundred patients admitted for rheumatic fever during this time. Observation of each patient included the history, physical examination with special attention to the heart, complete blood count, examination of urine and stools, sedimentation rate, electrocardiogram, X-ray, and fluoroscopic examination. The diagnosis was based on these findings. Only if at least one major manifestation such as polyarthritis, carditis, chorea, old history of rheumatic fever, or nodules was present with several of the minor ones, such as fever, rash, epistaxis, leucocytosis, elevated sedimentation rate, and anmmia was the diagnosis made. Two hundred and two of these patients, all enlisted personnel of the Army, were diagnosed as having rheumatic fever, and were followed for several months, the average stay in the hospital being six months. Many have been observed for one year or more before discharge.CLINICAL FEATURES Age ofPatients. The patients' ages ranged from 17-39 years; the largest groups were 18 years with 65, and 19 years with 63 patients. Between the ages of 17-20 there were 166 (82%); between the ages of 21-29 there were 29 (14%) and from the ages of 30-39 there were 7 (3%).Number of attacks before and after enlistment. There were 40 patients (20%) who gave a previous history of definite rheumatic fever. This compares with 24 per cent of the group reported by Quinn (1947). Both these figures are smaller than that of 36 per cent found by Manchester (1946) in his study of rheumatic fever in naval personnel. One hundred and sixty-two patients had their initial attack after enlistment.Family history. Twenty-four (12%) of the 202 patients gave a positive family history of rheumatic fever Month of onset. The greatest number ofcases occurred during the months of January, February, March, and April. As shown by other investigators, rheumatic fever may occur at any time of the year but is most frequent in the spring and autumn months.Prodromal disorders. There were 137 patients (77%) who had a preceding upper respiratory infection. The diagnoses in order of frequency were: catarrhal fever, tonsillitis, pharyngitis, laryngitis, and bronchitis. The term " catarrhal fever " implied a non-specific febrile illness of the upper respiratory tract. Many of the patients had throat cultures that showed a hmmolytic streptococcus. There were 19 patients who had scarlet fever before their rheumatic fever and 2 who *had fever of undetermined origin. Forty patients gave no history of any preceding infection. There were four insta ces of unusual infections including acute parotitis, acute mastoiditis, pneumonia, and appendicitis. The interval between the prodromal infections and onset of rheu-70 on 12 May 2018 by guest. Protected by copyright.