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June 3, 1939

Mundherde und Gelenkrheumatismus: Ein Beitrag zur Bakteriologie der oralen Herdinfektion

JAMA. 1939;112(22):2356. doi:10.1001/jama.1939.02800220122039

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The author believes that the teeth are the only controllable foci. Oral infection is only one of numerous foci, but it is important since the mouth is the great portal of entry to the gastrointestinal tract and is in intimate relationship to the upper respiratory tract, paranasal sinuses, mucosa, teeth, salivary ducts, tonsils and polypous growths. Schick thinks that the American allocation of the teeth as the focus in 10 per cent of cases is too conservative. The tonsils are second in importance. The author describes a gram-labile micrococcus which he and Fischer isolated. This organism was found in the blood stream of five of seven rheumatic patients; it was present in tonsils, granulomas and the pulp of dead teeth. Its pathogenicity is low. Other subjects considered are the blood picture, which is not characteristic, focal infections, polyarthritis rheumatica from the standpoint of pathologic anatomy and experimental work on Micrococcus

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