The symptoms of disease may be looked on as an expression of the reaction between the causative irritants and the invaded body. In most cases the irritants are micro-organisms, which sometimes cause local lesions at the site of entrance into the body, and almost invariably give rise to the generation of poisons, to the activity of which often the most pronounced phenomena of the disease are due. Febrile multiple arthritis may result from numerous causes, and it is possible that what is clinically designated acute rheumatism may have a like diversity of origin. Such evidence as exists indicates that acute rheumatism is an infectious disease, but, although a number of micro-organisms have been found in the articular and complicating lesions, there is as yet no agreement as to a specific etiologic factor. While the arthritis is generally considered the most characteristic manifestation of acute rheumatism, it can be conceived that
RHEUMATIC FEVER WITHOUT ARTHRITIS. JAMA. 1899;XXXIII(14):867. doi:10.1001/jama.1899.02450660057013
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