tis, or other mild infections, and
instances of two or more cases of rheumatism in one family or household
are most rationally explained as due to the spread of the precedent
infection from one member of the family to the other. Instances of the
direct transmission of the disease from one patient to another are
exceedingly rare.

Our view of the infectious causation of rheumatism, vague as it is, has
given us already our first intelligent prospect of prevention. Whatever
may be the character of a germ or germs, the vast majority of them agree
in making the nose and throat their first point of attack and of entry
into the system. Hence, vigorous antiseptic and other rational treatment
of all acute disturbances of the nose and throat, however slight, will
prove a valuable preventive and diminisher of the percentage of
rheumatism. This simply emphasizes again the truth and importance of the
dictum of modern medicine, "Never neglect a cold," since we are already
able to trace, not merely rheumatism, but from two-thirds to
three-fourths of our cases of heart disease, of kidney trouble, and of
inflammations of the nervous system, to those mild infections which we
term "colds," or to other definite infectious diseases.

Not only is this good _a priori_ reasoning, but it has been demonstrated
in practice. One of our largest United States army posts had acquired an
unenviable reputation from the amount of rheumatism occurring in the
troops stationed there. A new surgeon coming to take charge of the post
set about investigating the cause of this state of affairs, and came to
the conclusion that the disease began as, or closely followed,
tonsillitis and other forms of sore throat. He accordingly saw to it
that every case of tonsillitis, of cold in the head, or sore throat was
vigorously treated with local germicides and with intestinal
antiseptics and laxatives, until it was completely cured; with the
result that in less than a year he succeeded in lowering the percentage
of cases of rheumatism per company nearly sixty per cent.

At some of our large health-resorts, where great numbers of cases of
rheumatism are treated, it has been discovered that if a case of common
cold, or tonsillitis, happens to come into the establishment, and runs
through the inmates, nearly half of the rheumatic patients attacked will
have a relapse or new seizure of their rheumatism. Accordingly, a
rigorous and hawk-like watch is kept for every possible