By the removal of infection atria surgery may do much to prevent disease. That adenoids and diseased tonsils and gums are the port of entry for many serious infections, among which may be mentioned tuberculosis,2 typhoid, and diphtheria is well recognized, but it may be well to mention here the etiologic relationship these conditions seem to bear to more rare but yet important infections such as noma and acute poliomyelitis. The evidence is well-nigh conclusive that in the Scandinavian epidemic of poliomyelitis the contagion entered by way of the nasopharynx, and in apersonal letter H. W. Hill, of the State Board of Health of Minnesota, says he strongly suspects that the same is true of the late epidemic in his state.
After considerable study of the subject and a limited personal experience I am convinced that the important practical fact concerning noma is that it is above all else
PORTER MF. THE RÔLE OF SURGERY IN PREVENTIVE MEDICINE. JAMA. 1910;55(9):775–776. doi:10.1001/jama.1910.04330090049016
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