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January 6, 1940

FOCAL INFECTION AND SYSTEMIC DISEASE: A CRITICAL APPRAISALTHE CASE AGAINST INDISCRIMINATE REMOVAL OF TEETH AND TONSILS CLINICAL LECTURE AT ST. LOUIS SESSION

JAMA. 1940;114(1):1-6. doi:10.1001/jama.1940.02810010003001
Abstract

The concept of focal infection in relation to systemic disease is firmly established. The origin of many toxic or metastatic diseases may be traced to primary local or focal areas of infection. As examples, gonorrhea and gonococcic arthritis, furuncles and septicemia, tetanus and other self-limiting diseases may be cited. It is not surprising, therefore, that a similar relationship is thought to exist between various general systemic diseases of unknown origin and infections of the teeth, tonsils, nasal sinuses, appendix, gallbladder and cervix and infections elsewhere. Such a theory at least was elaborated and popularized chiefly after the publications of William Hunter and Frank Billings between 1910 and 1915. The enthusiasm thus aroused was further enhanced by the experimental work of Rosenow and others until focal infection with regard to infected teeth and tonsils seemed to be the cause of a great variety of diseases.

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