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Experimental subcutaneous rheumatic nodules
370
THE
dMERICAN
IIEhRT
JOURNAL
that skin sensitivity to filtrates from either series of strains was very much This inmore marked in rheumatic individuals than in the control subjects. creased sensitivity of rheumatic subjects was more clearly demonstrated with the anhemolytie than with the hemolytic forms. The skin sensitivity was most marked in subjects during the acute phases of rheumatism, negative reactions frequently occurring as convalescence was established. The author followed certain rheumatic subjects for a considerable period of time and was able to correlate the changes in the intradermal injection with the clinical condition of the subject and analogy could thus be drawn between her findings and those of Dochez and Stevens on experimental allergy. The author concludes that rheumatic fever is an allergic manifestation due to streptococci occurring in predisposed individuals. The evidence would point to a heterogeneous group rather than one particular strain of streptococcus as being responsible for rheumatic fever. Clawson,
B. J.:
Experimental
Rheumatic
Arteritis.
Arch.
Path.
6: 947,
1928.
In this paper a description is given of certain arterial lesions that were produced experimentally. Streptococci had been repeatedly injected into monkeys in an effort to produce glomerulonephritis. Microscopic examination showed in the kidneys of two of the monkeys vascular changes which bore a resemblance to the lesions described by Iilotz and Pappen.heimer and von Glahn. The t!vo monkeys had receive4 intravenous inject,ions of strains of Streptococcus viridans, isolated from the blood of patients having acute rheumatic fever. In another series of experiments in which many rabbits had had streptococci injected intravenously or subcutaneously in the effort to produce, experimentally, Asehoff bodies and subcutaneous rheumatic nodules, similar examples of arteritis were noted. This artcritis was commonly found in the hearts of rabbits into which streptoccocci had been injected intravenously, and practically always in the subcutaneous tissues of rabbits into vvhich the streptoeeocci had been injected subcutaneously. The result of these experiments show-cd that by injecting streptococci into rabbits and monkeys lesions could commonly bc produced in man which morphologically appeared similar to the rheumatic lesions in many. The morphology of the cellular reaction in this experimental arteritis was similar to that found in the Asehoff nodule and in rheumatic inflammation in other parts of the body. Clawson, B. J.: 6: 565, 19’8.
Experimental
Subcutaneous
Rheumatic
Nodules.
Am.
J.
Path.
In this paper a microscopic study is made of human subcutaneous rheumatic nodules and of the nodules produced experimentally in the subcutaneous tissue in rabbits by injecting streptococci. The purpose is to compare the structure of a known rheumatic lesion with that of a lesion which has been produced experimentally to arrive at further conclusions concerning t,he casual relation of streptococci to rheumatic injections. The nodules were produced in the subcutaneous tissues of rabbits by inin varying amounts and at different jecting different strains of streptococci Five different strains of streptococcus intervals under varying conditions. were used. Two of these were isolated from the blood of patients having acute rheumatic fever, one from the blood of a patient with subacute bacterial endocarditis and two from pus from sinuses in cases of sinusitis. Ten rabbits were injected intracutaneously and subcutaneously in many places with these organisms. Most of the animals had been previously injected
with strains of streptococci intra-arterially through the left ventricle of the heart. Others had been previously injected subcutaneously in one area with a mixture of streptococci and agar. The reaction “found in the injected areas depended on the virulence of the organism, the number of organisms injected and the time of the removal of The most virulent orgamsms tended to produce the nodules after injection. local abscesses, also if the area of injeetion was excised shortly after injection, there were signs of abscess formation. If organisms of low virulence were used or if small numbers of organisms were injected if the area of injection was excised at a later day there were found typical proliferative nodules at the site of injection. The reaction observed in these nodules was similar to those found in the nodules removed from human beings. Since these experimental nodules occur obviously as a result of injected streptococci, the probable conclusion is suggested that acute rheumatic fever and the type of inflammation associated with it are of streptococcic origin. Kreidler, William A. : arthritidis. J. Infect.
Biologic and Serologic Dis. 43: 415, 1935.
Studies
of
Streptococcus
Cardio-
The author has studied the biologic and serologic reactions of a series of 107 strains of this organism. Three strains were obtained from blood cultures, three from cultures of feces and the remainder from throat cultures. All the strains fermented glucose, sucrose, inulin, salicin and ra%nose; none, mannitol. Twenty-one strains failed to ferment lactose and failed to produce acid in milk. None liquefied gelatin or produced indol. Antigens prepared from each of the strains were agglutinated by a monovalent antiserum of S. cardioarthritidis in dilutions high enough to indicate that these strains fall into a definite serologic group and that group agglutinins play but a small part in the results obtained. When the foregoing facts are considered, there seems to be reason for the belief that these microorganisms biologically and serologically form a compact species of streptococci. The failure of some of the strains to ferment lactose and the difference in the agglutinability of the strains, suggest that there may exist, within the species; immunologic subtypes of this organism. Belk, William P., and Fendrick, Edward: with Streptococcus Cardio-Arthritidis.
The Arch.
Lesions in Animals Path. 6: 812, 1928.
Inoculated
This report is based on the anatomic lesions found in seven rabbits and two horses inoculated with repeated injections of Streptococcus eardio-arthritidis. The animals were given viable twenty-four hour cultures suspended in saline solution. The lesions in the various tissues of the body resembling those seen in human rheumatic fever were identified. These lesions are described in the paper. Epicarditis appeared in two of the rabbits; nonpurulcnt focal myocarditis in six; mural endoearditis in three; valvular endocarditis in four; arteritis in four; myositis in three; bursitis in one; glomerular nephritis in one; infarcts of spleen carditis, focal myocarditis, valvular endocarditis, arteritis and pneumonitis apand kidney in one; aortitis in three and pneumonitis in all the animals. Peripeared in both horses. Poynton, Sept. In heart
F. John: 15, 1928.
Rheumatic
these 3 lectures, disease. First,
the the
Heart
Disease
in
Childhsood.
author discusses three particular correlation of the pathological
Lancet
phases lesions
of of
215:
537,
rheumatic the heart
THE
dMERICAN
IIEhRT
JOURNAL
that skin sensitivity to filtrates from either series of strains was very much This inmore marked in rheumatic individuals than in the control subjects. creased sensitivity of rheumatic subjects was more clearly demonstrated with the anhemolytie than with the hemolytic forms. The skin sensitivity was most marked in subjects during the acute phases of rheumatism, negative reactions frequently occurring as convalescence was established. The author followed certain rheumatic subjects for a considerable period of time and was able to correlate the changes in the intradermal injection with the clinical condition of the subject and analogy could thus be drawn between her findings and those of Dochez and Stevens on experimental allergy. The author concludes that rheumatic fever is an allergic manifestation due to streptococci occurring in predisposed individuals. The evidence would point to a heterogeneous group rather than one particular strain of streptococcus as being responsible for rheumatic fever. Clawson,
B. J.:
Experimental
Rheumatic
Arteritis.
Arch.
Path.
6: 947,
1928.
In this paper a description is given of certain arterial lesions that were produced experimentally. Streptococci had been repeatedly injected into monkeys in an effort to produce glomerulonephritis. Microscopic examination showed in the kidneys of two of the monkeys vascular changes which bore a resemblance to the lesions described by Iilotz and Pappen.heimer and von Glahn. The t!vo monkeys had receive4 intravenous inject,ions of strains of Streptococcus viridans, isolated from the blood of patients having acute rheumatic fever. In another series of experiments in which many rabbits had had streptococci injected intravenously or subcutaneously in the effort to produce, experimentally, Asehoff bodies and subcutaneous rheumatic nodules, similar examples of arteritis were noted. This artcritis was commonly found in the hearts of rabbits into which streptoccocci had been injected intravenously, and practically always in the subcutaneous tissues of rabbits into vvhich the streptoeeocci had been injected subcutaneously. The result of these experiments show-cd that by injecting streptococci into rabbits and monkeys lesions could commonly bc produced in man which morphologically appeared similar to the rheumatic lesions in many. The morphology of the cellular reaction in this experimental arteritis was similar to that found in the Asehoff nodule and in rheumatic inflammation in other parts of the body. Clawson, B. J.: 6: 565, 19’8.
Experimental
Subcutaneous
Rheumatic
Nodules.
Am.
J.
Path.
In this paper a microscopic study is made of human subcutaneous rheumatic nodules and of the nodules produced experimentally in the subcutaneous tissue in rabbits by injecting streptococci. The purpose is to compare the structure of a known rheumatic lesion with that of a lesion which has been produced experimentally to arrive at further conclusions concerning t,he casual relation of streptococci to rheumatic injections. The nodules were produced in the subcutaneous tissues of rabbits by inin varying amounts and at different jecting different strains of streptococci Five different strains of streptococcus intervals under varying conditions. were used. Two of these were isolated from the blood of patients having acute rheumatic fever, one from the blood of a patient with subacute bacterial endocarditis and two from pus from sinuses in cases of sinusitis. Ten rabbits were injected intracutaneously and subcutaneously in many places with these organisms. Most of the animals had been previously injected
with strains of streptococci intra-arterially through the left ventricle of the heart. Others had been previously injected subcutaneously in one area with a mixture of streptococci and agar. The reaction “found in the injected areas depended on the virulence of the organism, the number of organisms injected and the time of the removal of The most virulent orgamsms tended to produce the nodules after injection. local abscesses, also if the area of injeetion was excised shortly after injection, there were signs of abscess formation. If organisms of low virulence were used or if small numbers of organisms were injected if the area of injection was excised at a later day there were found typical proliferative nodules at the site of injection. The reaction observed in these nodules was similar to those found in the nodules removed from human beings. Since these experimental nodules occur obviously as a result of injected streptococci, the probable conclusion is suggested that acute rheumatic fever and the type of inflammation associated with it are of streptococcic origin. Kreidler, William A. : arthritidis. J. Infect.
Biologic and Serologic Dis. 43: 415, 1935.
Studies
of
Streptococcus
Cardio-
The author has studied the biologic and serologic reactions of a series of 107 strains of this organism. Three strains were obtained from blood cultures, three from cultures of feces and the remainder from throat cultures. All the strains fermented glucose, sucrose, inulin, salicin and ra%nose; none, mannitol. Twenty-one strains failed to ferment lactose and failed to produce acid in milk. None liquefied gelatin or produced indol. Antigens prepared from each of the strains were agglutinated by a monovalent antiserum of S. cardioarthritidis in dilutions high enough to indicate that these strains fall into a definite serologic group and that group agglutinins play but a small part in the results obtained. When the foregoing facts are considered, there seems to be reason for the belief that these microorganisms biologically and serologically form a compact species of streptococci. The failure of some of the strains to ferment lactose and the difference in the agglutinability of the strains, suggest that there may exist, within the species; immunologic subtypes of this organism. Belk, William P., and Fendrick, Edward: with Streptococcus Cardio-Arthritidis.
The Arch.
Lesions in Animals Path. 6: 812, 1928.
Inoculated
This report is based on the anatomic lesions found in seven rabbits and two horses inoculated with repeated injections of Streptococcus eardio-arthritidis. The animals were given viable twenty-four hour cultures suspended in saline solution. The lesions in the various tissues of the body resembling those seen in human rheumatic fever were identified. These lesions are described in the paper. Epicarditis appeared in two of the rabbits; nonpurulcnt focal myocarditis in six; mural endoearditis in three; valvular endocarditis in four; arteritis in four; myositis in three; bursitis in one; glomerular nephritis in one; infarcts of spleen carditis, focal myocarditis, valvular endocarditis, arteritis and pneumonitis apand kidney in one; aortitis in three and pneumonitis in all the animals. Peripeared in both horses. Poynton, Sept. In heart
F. John: 15, 1928.
Rheumatic
these 3 lectures, disease. First,
the the
Heart
Disease
in
Childhsood.
author discusses three particular correlation of the pathological
Lancet
phases lesions
of of
215:
537,
rheumatic the heart