STREPTOCOCCUS MUCOSUS 351 



the true streptococci. As would be expected from its capsulation, its 

 virulence is very powerful and serum reactions are not easily carried 

 out. A further discussion, of the immune serum reactions with this 

 organism is included in the chapter on pneumococci, page 363. 



STREPTOCOCCI AND RHEUMATISM 



In 1910 Poynton and Paine 1 described a diplococcus which they 

 obtained from eight cases of acute rheumatic fever and with which 

 they were able to produce lesions in rabbits which they considered 

 typical of rheumatism. The organism was recovered from the blood, 

 the pericardial fluid, or the tonsil of their patients. They described a 

 minute Gram-negative diplococcus growing best in acid media and 

 under anaerobic conditions, but capable of growth on the surface of ordi- 

 nary media. Many investigators have attempted to confirm their work, 

 but with negative results for the most part, though some have found 

 streptococci and diplococci from rheumatic lesions. Recently Rosenow 2 

 has reported the isolation of a streptococcus from the joints of seven 

 cases of articular rheumatism. He was also able to produce non- 

 suppurative arthritis, endocarditis, and pericarditis in rabbits with 

 these cultures. He describes them as intermediate in character between 

 the streptococcus viridans and streptococcus hemolyticus. 



More recently Rosenow 3 has reported the production of gastric 

 ulcers in rabbits and dogs with streptococci of a certain grade of viru- 

 lence. He has also obtained streptococci from human peptic ulcers 

 which showed a remarkable " affinity " for the gastric mucous membranes 

 of experimental animals. 



Rosenow seems inclined to think on his later work that individual 

 strains of streptococcus may acquire predilections for definite tissues, 

 consequently causing rheumatic lesions, muscular lesions, lesions in the 

 gastric mucosa, etc. He bases this opinion both on experimental work 

 and upon observations in patients. Judgment upon this point of view 

 must for the present be held in abeyance, yet it seems to us more likely 

 that specific localization of streptococci, especially in connection with 

 rheumatism, may find an explanation in the hypersusceptibility of in- 

 dividual tissues to the organism, such as that indicated in the work 

 of Faber who sensitized joints with extracts of streptococci, subse- 

 quently producing lesions in these joints by intravenous injections of 

 the microorganisms themselves. 



1 Poynton and Paine, Lancet, 1900, ii, 861, 932. 



2 Rosenow, Jour. A. M. A., 1913, Ix, 1223. 



3 Rosenow, Jour. A. M. A., 1913, Ixi, 1947, 2007. 



