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THE ETIOLOGY AND PATHOLOGY OF ARTHRITIS

RALPH PEMBERTON, M.D.
JAMA. 1926;87(16):1253-1258. doi:10.1001/jama.1926.02680160001001.
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It is common knowledge that infections, especially focal in nature, have much to do with the causation of rheumatoid disability. Close students of the subject know, however, and none better than orthopedists, that other factors operate to precipitate and especially to perpetuate the disease. The great importance of the doctrine of focal infection is not to be minimized but it is also of the highest importance to determine the limitations of this principle and, above all, to determine how it operates. There has been a temptation to regard the phenomena of arthritis as due solely to the local depredations, so to speak, of micro-organism, especially streptococci, in situ; but it can easily be shown that proof to this end is far from complete and that other kinds of influences must be considered in both the development and the subsidence of the disease. The study of arthritis cannot be adequately conducted

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