OUT of the great wilderness of pain the word “rheumatism” was born. It conveys an idea: it is not a diagnosis. Fortunately, it satisfies the less exacting laymen, but, unfortunately, too many members of our profession frequently submit it as a diagnosis to obviate a painstaking and skillful examination. “Rheumatism” is the refuge of careless doctors, who frequently learn too late that pain is a symptom of malignancy. Joint troubles are inevitable when joint conditions become chronic. From this fact there has developed a bewildering nomenclature, irrational ideas of etiology, confusing attempts at pathological classifications, and a mass of therapeutic hodge-podge, unrivalled by any disease except tuberculosis. When pulmonary tuberculosis was “consumption,” glandular tuberculosis was “King's evil,” and joint tuberculosis was “white swelling.” Miasma was the cause and the King's touch the cure. In our thinking concerning chronic infective arthritis, we are not far removed from the idea of the King's touch. It was only in 1907 that Nichols and Richardson, finding interest in the subject of arthritis from a pathological viewpoint, produced a series of observations which have remained classical in their description, and for a long time to come will form the basis upon which the condition is studied. They were not interested in the treatment, but they did reach the conclusion that, whether or not it was hypertrophic, atrophic, or mixed in character, all manifestations were infectious in origin, and were probably caused by the same organisms. The number of classifications of arthritis is almost as numerous as the number of men who have made a study of the condition. We claim nothing new, other than perhaps our approach to the practical business of diagnosing and treating arthritic conditions. We accept the classifications made by various workers as correct. When studying and treating chronic diseases we must be cautious in arriving at conclusions. We must keep in mind that there are but few healthy persons, and as investigators of particular conditions we must not be misled by our findings. Many obscure factors enter into the cause of disease, which, though obscure, may be very real. Identity of lesion does not signify identity of cause, and there are some peculiar fads unexplained in symbiotic relationships. The streptococcus causes many diseases and sometimes causes the train of symptoms and physical findings designated as arthritis. One may say that a patient suffering with a chronic streptococcic infection becomes physiologically old, regardless of age. Joint lesions, especially cartilagenous lesions, may have relatively slight power of repair, and with any method of actual cure, the functional restoration is impossible. The pathology of streptococcic infected tissue tends to progress, with long periods of remission. Many enthusiastic claims of cures in reality but represent these remissions.