The recent work of Shaw1 again calls attention to the problem of the microbic etiology of acute articular rheumatism or acute rheumatic fever. This has been a vexed problem for many reasons. As will have become apparent to the readers of The Journal in which this subject has been discussed many times, there have been various views held as to the cause, some proceeding from a purely a priori standpoint, others based on more or less imperfect evidence. The older view that a metabolic or autotoxic process was responsible has latterly been largely supplanted by the microbic intoxication or infection theory, having as its basis the analogies found in other infectious diseases and also certain bacteriologic findings. The views which have been held concerning the microbic cause are: 1, That it is a toxic disease caused by the absorption of bacterial toxins from a local point of infection (presumably
THE ETIOLOGY OF RHEUMATIC FEVER. JAMA. 1904;XLII(9):595. doi:10.1001/jama.1904.02490540027004
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