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JAMA. 1903;XL(1):39. doi:10.1001/jama.1903.02490010047009.
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The pathogenesis of the arthropathias is still in doubt. The rôle of trauma, analgesia, neglected rheumatic effusions, rarefaction, epiphyseal separation and bone atrophy as an end result of syphilis are still denied as causative factors by many who look on the condition as induced in some manner by the peculiar and inherent nature of the disease itself. Since the macroscopic, chemic and histologic investigations of Regnard, Féré and Blanchard on the bone changes in tabetics, no one has seriously doubted the importance of these tissue alterations as factors in the arthropathias of this disease. However, the extensive study of Kienböck six years agoon tabetics by means of radiography gave no abnormal picture, neither in the arthropathic joints nor in any of the free articulations of such patients. While this investigation was a surprise to those who believed in the theory of rarefaction and bone atrophy, it failed of


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