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The authors start out with essentially the following premise. The Endameba buccalis is found in pus from pyorrhea pockets. Emetin hydrochlorid injected into a patient having "alveolodental pyorrhea" causes the protozoa to disappear; in addition, the clinical appearance of the tissues involved in the disease is much improved after its use; therefore Endameba buccalis is the cause of pyorrhea, and emetin hydrochlorid is specific for the disease. The statement is so positively made that one at first is lead to accept it. But Koch's laws have not been satisfied; there is room for doubt as to the accuracy of the premise. Many other organisms are present in pyorrhea pockets which may be the cause of the disease. These too may be influenced by emetin, either directly or by causing changes in the tissues, rendering them unsuitable for bacterial action; therefore, one cannot unqualifiedly accept without further proof the statement that
Alveolodental Pyorrhea. JAMA. 1915;LXV(14):1206–1207. doi:10.1001/jama.1915.02580140056032
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