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The author observed cases in which signs and changes of septic endocarditis remained stationary for long periods. Moreover, the intensity of functional changes did not correspond to that of organic changes. Palpitations, cardiac pains, suffocation and dyspnea were considerable, while the cardiac murmurs or occasional dilatation of the heart were insignificant. The third particular feature of the cases consisted in the presence of mental disturbances. Hypochondriasis, melancholia and depression were the signs of a mental reaction. There was a persisting fever. The patient's history pointed always to a sore throat or to influenza as the origin of the "endocarditis." The tonsils proved to be responsible for the fever; removal or cauterization of the tonsils was followed by lowering of the temperature. Further examination revealed that the cardiac phenomena simulating endocarditis were associated with irritation of a certain section of the sympathetic nervous system. The connection between a chronic infection of
Sertse i Grippoznoe Vospalenie Zubov i Mindalin.. JAMA. 1930;95(25):1935-1936. doi:10.1001/jama.1930.02720250057033