REMOTE MANIFESTATIONS OF FOCAL DENTAL INFEC- 
TIONS, WITH CASE REPORTS? 
By RicarRDO FERNANDEZ 
Assistant Professor of Roentgenology, University of the Philippines, and 
Chief of the Department of Physical Therapy, Philippine 
General Hospital 
It is a common practice in the treatment of certain articular 
and muscular affections of various types to make clinical and 
laboratory examinations with a view to determine the presence 
of so-called chronic rheumatism, acute rheumatic fever, or uric- 
idemia or gout; hence the custom of requesting urine examina- 
tion to enable the practitioner to determine the total amount of 
uric acid, and also to estimate the quantity contained in the 
blood. An elaborate medical and dietetic treatment is then 
given, coupled sometimes with physical therapy, but in the 
majority of instances such treatment is a failure. 
There is no pretension of originality in my paper; the motive 
that induced me to prepare it was to suggest to my confréres 
that in such affections they may depart from the line of investi- 
gation heretofore followed. 
Sinclair Tousey, in the preface of his monograph on “‘Roent- 
genographic diagnosis of dental infection in systemic diseases,” 
mentions the observation on the wife of an eminent jurist, who 
died as a result of an infection localized in the socket of a tooth; 
this focal infection was diagnosed rather late by means of X-ray. 
He says: 
The widest publicity should be given to the fact that greatly varying 
and sometimes serious or fatal systemic diseases and those affecting 
remote organs are often due to infection connected with the teeth or with 
the pneumatic sinuses of the face. The infected foci are discoverable by 
the X-rays. Some of these cases are cured by treatment of the oral 
lesion and some require also autogenous vaccination with a_ bacterial 
culture from the pus in the oral lesion. 
Hardly any importance has been given to alveolar abscesses 
as possible causes of serious and remote disorders in the body; 
although it has been always considered important to detect the 
presence of pus in any region of the body, so as to account for, 
1 Read before the Manila Medical Society December 3, 1917. 
89 
