32 Trans. Acad. Scr. of St. Louss 
originated from a distant primary spot of infection, 
just as weed seeds are blown from our neighbor’s gar- 
den to our own. The great problem is to find out from 
what garden these seeds come, and eradicate them there. 
We may strike it in the first place by the removal of an 
infected tooth or tonsil, but the chances are we will not. 
Theoretically we should continue the search until the 
original focus is found; a prospect entailing great diag- 
nostic energy and skill and often severe abdominal oper- 
ations. Only too often the patient gives out before the 
doctor. A casual mention of some of the diseases known 
to be due to focal infection may indicate how hard the 
problem is. Valvular disease of the heart, endocarditis, 
hardening of the arteries, pericarditis, osteomyelitis, 
periostitis, neuritis, herpes, appendicitis, inflammation 
of the gall-bladder, stomach and duodenal ulcer, and the 
greatest incapacitator of them all, chronic arthritis. 
The list of sources from which an infection may arise 
primarily and from which other secondary serious dis- 
eases may originate is even larger. I might mention 
pyorrheea, abscesses about the teeth and gums, tonsilitis, 
inflammation of the nasal sinuses, all sorts of bron- 
chial conditions, pleurisy, multiple small ruptures of 
the colon, pyelitis, inflammation of the kidneys, also of 
the tubes and ovaries, and special glands, hemorrhoids, 
fistula, even slight inflammations about the finger nails. 
So the problem is complicated and implies for its suc- 
cessful issue first an accurate diagnosis of the disease 
—the diagnosis in part to determine whether the dis- 
ease be one that might originate from a primary infec- 
tion, a very difficult matter in itself. Secondarily is im- 
plied the eradication of all possible sources of primary 
infection. The wonder is, not that the method does not 
always succeed, but that it ever does. Now the special- 
