Although a specific etiologic factor has not yet been isolated, it is generally agreed that acute rheumatism is an infectious disease, and it has of late more especially been pointed out that the tonsils often constitute the portal of entry. Whether any etiologic relation exists between acute, subacute and chronic rheumatism is a matter concerning which more doubt exists. It is possible that acute rheumatism proper, apart from various forms of infective arthritis, is a specific disease of uniform etiology, although it is held by some that it is really a variety of mild, attenuated pyemia. The other varieties of so-called rheumatism, it is suggested, may be due to a modification of the same infective process; or, at times, at least, they may not be rheumatic at all in the specific sense. The tonsils seem to have been the portal of entry not only for the articular infection,
THE TONSILS AS A PORTAL FOR RHEUMATIC INFECTION. JAMA. 1901;XXXVI(3):190. doi:10.1001/jama.1901.02470030046013
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