RHEUMATIC FEVER. 525 



ever. Not infrequently the vegetations contain 

 staphylococci as well as streptococci. 



Since 1867, when Salisbury described a fungus Rheumatic 

 which he called Zymo tosis translucens^Taany micro- Fever * 

 organisms have been described and cultivated from 

 the joints, blood, endocarditic and pericarditic 

 lesions and from the tonsils in acute articular 

 rheumatism. Among them were the "Monadinen" 

 of Klebs (1875), short bacilli by Wilson (1885) 

 and others, staphylococci and streptococci by 

 Weichselbaum (1885) and by many others, and 

 an anaerobic bacillus resembling that of anthrax 

 by Achalme (1890). Streptococci have been found 

 more frequently than other organisms. The ba- 

 cillus of Achalme acquired considerable prominence 

 at one time, being found in rheumatism in a num- 

 ber of cases, but it has been found since in other 

 conditions, and normally, and Achalme himself 

 gave up his original claims for its etiologic 

 significance. The organism, possibly, is identical 

 with B. aerogenes capsulatus of Welch (Harris). 

 Many of the observations are of little value, since 

 the cultures were made postmortem, when contami- 

 nations and agonal invasions by other organisms 

 could not be excluded. The conditions were very 

 confusing, however, since the injection of pure 

 cultures occasionally produced arthritis, peri- 

 carditis and endocarditis in animals. This was 

 the case with a short anaerobic bacillus or diplo- 

 bacillus cultivated by Thiroloix, and by Triboulet, 

 Coyon and Zadoc (1897). 



In 1897-98 Triboulet and Coyon cultivated from 

 the blood of five cases of rheumatic fever a diplo- 

 coccus, pure cultures of which caused arthritis, 



