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About the second week of January, 1912. it became evident in Baltimore that an unusual type of tonsillitis. with adenitis, peritonitis and septicemic complications was epidemic. Physicians practicing internal medicine could not fully differentiate the variety of tonsillarpharyngeal infection prevailing from the common strepto-staphylococcic variety.
It was not until the end of February and March that the realization dawned on the Baltimore profession that they were dealing with a virulent manifestation of some microorganism that had taken on a new malignancy—that had assumed a new pathologic rôle.
Of forty-three cases studied clinically and by bacteriologic methods from January 23 to March 28, 1912, occurring in the practice of Drs. Sylvan Rosenheim, Claude Stoncifer, B. F. Phillips, Leo Cohen, my own and other physicians, the following complications occurred:
Thirty patients had cervical glands enlarged.
Ten had one or more submaxillary glands larger than a hen's egg (6 by 2
HIRSHBERG LK. MALIGNANT PNEUMOCOCCUS TONSILLITIS. JAMA. 1912;LVIII(16):1189-1190. doi:10.1001/jama.1912.04260040205006