THE STREPTOCOCCI 423 



on the surface of ordinary media. Recently, Rosenow 64 reported 

 the isolation of streptococcus viridans from the joints of seven cases 

 of articular rheumatism. He also claimed that he could produce 

 non-suppurative arthritis, endocarditis and pericarditis in rabbits 

 with these cultures. He described the organisms as intermediate 

 in character between the ordinary viridans and the hemolyticus. 

 These claims have led to a great deal of subsequent experimentation 

 and speculation. There is no question about the fact that viridans 

 strains have often been isolated from cases of rheumatism, but it 

 is not unlikely that equal care in similar attempts would have 

 succeeded in isolating these ubiquitous organisms from many other 

 groups of disease. Swift and Kinsella 65 have made a particularly 

 careful study of this problem, and, though working with great care 

 and experience, obtained the viridans from only 8.3 per cent of 

 58 cases. In no case did they obtain the organisms from the joints 

 themselves, and we ourselves can attest to the fact that the large 

 majority of direct cultures taken from rheumatic joints prove quite 

 sterile. While, therefore, the role of the viridans in endocarditis 

 is clear, its relationship to rheumatic fever is entirely unproven at 

 the present writing. 



The same uncertainty exists concerning its association with an- 

 other disease which is frequently classified with the two diseases 

 mentioned, namely, chorea. A number of writers, notably Quigley, 66 

 have found the viridans in the blood of chorea cases, but nothing 

 more definite than this has been noted. 



Rosenow, 67 too, has recently claimed that there was an associa- 

 tion between viridans-like streptococci and poliomyelitis. In the 

 special section on poliomyelitis in this book we will deal with the 

 globoid or coccoid bodies isolated by Flexner and Noguchi. 68 Some 

 two or three years, after these observations were made, Rosenow 

 and Towne, 69 as well as Mathers, 70 reported that they had found 

 streptococci of the viridans group in the central nervous system of 

 cases of poliomyelitis. Rosenow and Wheeler 71 grew these cocci 



"Rosenow, Jour. A. M. A., 60, 1123 and 61, 1947 and 2007. 

 65 Swift and Kinsella, Arch. Inter. Med., 19, 1917, 381. 

 "Quigley, Jour. Infec. Dis., 22, 1918, 198. 



67 Rosenow, 'Jour. Infcc. Dis., 22, 1918, 379. 



68 Flexner and Noguchi, Jour. Expcr. Med., 18, 1913, 461. 

 e " A'o.srnow and Townc, Jour. Med. Research, 36, 1917, 175. 

 711 Mather*, Jour. A. M. A., '67, 1916, 1019. 



71 Eosenow and Wheeler, Jour. Infec. Dis., 22, 1918, 281, 



