Two diseases, the cause of cardiac dysfunction, syphilis and rheumatic fever, are seldom reported as associated in studies of these two diseases. Cowan and Rennie,1 in a study of one hundred and four patients suffering from disease of the aortic valves, found definite rheumatic disease of the mitral valve in 3.1 per cent of those with syphilis of the heart. Cotton2 found among fifty patients with aortic insufficiency with an average age of 31 years that 2 per cent gave a history of syphilis. Fordyce3 reported nine cases of children with rheumatic heart disease with a severe course in whom asymptomatic congenital syphilis was discovered. The contribution of Von Glahn and Wilshusen4 included the pathologic study of two cases of recent rheumatic myocarditis superimposed on syphilitic aortitis. In the Joseph Sailer Cardiac Clinic of the Philadelphia General Hospital, four cases of frank rheumatic heart disease with