. Archives of physical medicine and rehabilitation . cs. ankles, hips, ■ History: Acute onset of jointtroubles eiplit years vgo Iollowing severe attack of jaundiceand dysentery, in bed six months. Progressive involvementof large joints, until now all are ankylosed. Diagnosis:Teeth, tonsil*, and antra negative. Duodenal with ankylosis of all large Fig. 7—Mr. McX., age rid. Complaint: Epigastric pain lastingtwo or three days and occurring every two or lliree pain in riglit lumbar region. Pain in back whenturning in bed. History: All co
. Archives of physical medicine and rehabilitation . cs. ankles, hips, ■ History: Acute onset of jointtroubles eiplit years vgo Iollowing severe attack of jaundiceand dysentery, in bed six months. Progressive involvementof large joints, until now all are ankylosed. Diagnosis:Teeth, tonsil*, and antra negative. Duodenal with ankylosis of all large Fig. 7—Mr. McX., age rid. Complaint: Epigastric pain lastingtwo or three days and occurring every two or lliree pain in riglit lumbar region. Pain in back whenturning in bed. History: All complaints date back teeth removed four years ago. Diagno-tis: Duo-denal ulcer and duodenal adhesions. Chronic appendix. Spon-dylitis of second and fifth lumbar vertebra. mals gall-bladder disease or appendi-citis, or, by a lengthened process oflaboratory culture and subculture,arthritic changes. So that it is gen-erally admitted that infective processesin teeth or tonsils or nasal accessorys;nuses are rightly regarded as possible. VlK. s—Mr. C. age 07. Coiiiiilainl. Painleft knee. History: Dnies back |fnol<: Teeth. tonHllM and sinusesixKnIlve. Hnnrt< of cecum and .sigmoid< Left knee Joint. foci for the production of gastro-intestinal and arthritic lesions. A laudable field of activity forsome enterprising bacteriologist wouldbe the attempt to produce arthriticchanges in animals by injecting purecultures of bacteria recovered fromnot only gall-bladders and appendices,but from under severed duodenal andcolonic bands. In our opinion, based on clos:- ob-servation of a considerable series ofcases, the production of chronic arth-ritis is dependent upon foci in thegastro-intestinal tract even more fre-tniently than upon those found in ton-sils, or teeth, or nasal accessory sinuses. Further we are convinced thatwhere the two classes of lesions co-exist in any individual suffering fromchronic arthritis, it will be of littlevalue
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