In a recent review of the infectious diseases, Packard1 considers the various theories in regard to the etiology of acute articular rheumatism. There is little or no foundation for the humoral and the nervous theories. The principal support of the humoral theory was the similarity between articular rheumatism and gout, the joints being affected in both. The lactic-acid theory grew out of this apparent relationship. But the fact that lactic acid may cause articular pain and swelling does not prove that it is the cause of acute rheumatism, because there is more to rheumatism than articular inflammation. How should the excessive production of lactic acid be explained? The nervous theory was the outgrowth of the similarity between the joint affections of acute rheumatism and of certain nervous diseases. There is no good reason to be advanced in favor of nervous joint centers. There is no real evidence of any
ETIOLOGY OF ACUTE ARTICULAR RHEUMATISM. JAMA. 1900;XXXIV(21):1346–1347. doi:10.1001/jama.1900.02460210052008
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