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October 1927


Author Affiliations

Director II Medical Clinic, University of Munich MUNICH, GERMANY

Arch Intern Med (Chic). 1927;40(4):399-419. doi:10.1001/archinte.1927.00130100003001

When one considers diseases of the joints, two pictures arise before one's eyes.

One is that of a boy aged about 20, immovable in bed because of severe pain in his swollen joints, high temperature and palpitation of the heart. After some days or several weeks, the pain and swelling of the joints will disappear perfectly and he will recover, but a mitral incompetence remains and he will be a lifelong invalid. Several years later, a second or third attack of rheumatic fever appears, and perhaps at last a recurrent endocarditis brings on death with the symptoms of a septic disease.

The second picture is that of a woman in an almshouse. For many years, she has suffered from pain in the fingers, wrists, knees and other joints. Most of the joints become more and more stiff and manifest deformities of all kinds. The whole day long she sits in

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