METHODS OF ELICITATION OF PHENOMENON 1 89 



^vith tlironibosis and necrosis of the vessels with exudation of 

 polymorphonuclear leucocytes and hemorrhages. 



Moritz and Morley failed to produce the phenomenon of re- 

 activity to bacterial filtrates in plenral and peritoneal cavities. 



I.atteri ( 19^^54) injected 0.5 ex. of B. coli or B. ty})li()sus hltrate 

 into the appendix of rabbits exposed by median laparotomy. 

 T\venty-four honrs later an intravenc^iis injection of one of the 

 above filtrates was made. The controls consisted of 4 rabbits, 

 which either recei\'ed the preparatory injection of the toxic mate- 

 rial and no intra\'enoiis injection, or a preparatory injection of 

 physiological saline and an intravenous injection of the bacterial 

 filtrate. Twenty-foiu" horns after the intravenous injection, a second 

 laparotomy was performed. Microscopically, the appendix ap- 

 peared negative. The incision was closed and the rabbits were 

 killed tAventy-foiu' hoins after the laparotomy, i.e., forty-eight 

 hours after the intravenous injection. Of 14 rabbits used, 3 were 

 definitely positive and one had a slight local hemorrhagic reaction. 

 The appendices were s^vollen, tingid and intensely hyperemic. 

 Histologically, there was an alteration in the mucosa, submucosa 

 and subserous layers which consisted of intense vascular dilatation, 

 hemorrhage, leucocytic infiltration and thrombosis of the small 

 \essels. No similar lesions were seen in foiu" control experiments. 



Ka\etzky (1935) reprodticed the phenomenon in rabbit joints 

 by the use of combined intraarticidar and intravenous injections 

 of streptococcus culture filtrates. The changes observed were hy- 

 peremia, edema of periarticidar tissties and exudation into the 

 artictilar cavity. This author draws attention to certain points of 

 similarity bet^veen rheinnatism and the phenomenon in the joints, 

 ^vhich in his opinion, suggest that the mechanism of the johenom- 

 enon may be similar to the pathogenesis of lunnan rheinnatism, 

 namely: the possibility of reproduction of the phenomenon ^vith 

 streptococcus products; vascidar involvement accompanied by 

 comparatively insignificant changes in the soft tissues of joints and 

 in the cartilage; transitory natine of the lesions; and finally, a short 

 incubation period necessary for appearance of the symptoms. 

 According to this author, the pathogenesis of hiunan rheumatism 

 may consist of localization in the joints of bacterial active prin- 

 ciples originating from some distant bacterial focus ^vith subse- 

 quent elicitation of the state of reactivity. The localization may 

 be conditioned by exposure to cold or to some other non-specific 

 stimulation. The lesions may then be produced by the effect of the 



