THE DIFFERENTIAL INCIDENCE OF RHEUMATIC FEVER IN THE HISTORIES OF PARANOID AND NON-PARANOID SCHIZOPHRENICS

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Abstract
An excess of rheumatic fever histories was found among schizophrenics who exhibited 2 main characteristics: a non-paranoid schizophrenic diagnosis, and an early onset age. Socio-economic condition, insofar as it could be tested by I.Q. and schooling level, was found not to contribute significantly to this result. Hypoplastic capillary structure and hypofunction of the adrenal cortex have been claimed in both rheumatic fever and schizophrenia. Critical statistical tests to see whether these constitute a legitimate source of linkage between the 2 diseases are suggested. A tentative formulation is presented suggesting that capillary hypoplasia, adrenal cortical hypofunction, and rheumatic inflammation of the capillaries may act synergistically to produce capillary damage in the brain, the type of generalized brain trauma ensuing being conducive to a schizophreniform psychotic breakdown. Rheumatic fever, if it contributes at all to the schizophrenic process, is probably involved in only a rather small portion of the cases, and is seen as a possible complication of the problem of schizophrenia rather than as a solution to the whole problem.

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