The Heart in Arthritis Deformans

The association of acute articular rheumatism or acute rheumatic fever with cardiac lesions is too well known to warrant comment. That organic cardiac defects are frequently found in patients with chronic multiple arthritis is not so generally recognized. Indeed, Bouillaud, who was the first to emphasize the importance of acute articular rheumatism in the etiology of heart disease (1836), taught that the heart was not involved in subacute or chronic arthritis. Todd,1in 1843, was probably the first to describe a case of arthritis deformans with associated cardiac lesions, and, three years later, Romberg2recorded a similar case. Charcot3confirmed these observations and wrote: "Cardiac lesions are found pretty frequently in nodular rheumatism. There has generally been in these cases at a former period an attack of acute rheumatism; but I have collected a considerable number of cases in which endocarditis has developed in chronic rheumatics without