690 A MANUAL OF BACTERIOLOGY 



destruction of tissue. Dobell, however, considers that this 

 amoeba has no pathogenic action. 



RHEUMATISM (ACUTE). The opinion has gained ground of 

 late years that acute rheumatism is an infective disease. A 

 number of observers have isolated streptococci and micrococci 

 in this disease. Menzer considers that rheumatic fever is not 

 due to any one organism, but is a particular reaction in predis- 

 posed persons to various microbes, especially streptococci. In 

 1897 Achalme isolated an anaerobic anthrax-like bacillus from 

 several cases. This bacillus agrees in all its characters with the 

 B. Welchii as shown by the Author 1 ; it is probably a terminal 

 infection or a contamination. Poynton and Paine 2 in 1899 

 obtained from eight successive cases a diplococcus (I), rheumaticus) 

 which in broth develops into a streptococcus. Injected intraven- 

 ously into rabbits the diplococcus frequently produces enlarge- 

 ment and inflammation of the joints with effusion, and occasion- 

 ally valvulitis and endocarditis. In man the organism was 

 demonstrated in the vegetations, pericardium, tonsils, and rheu- 

 matic nodules, and has been isolated from the blood, pericardial 

 fluid, cardiac vegetations, and tonsils. 



Andrewes and Horder found that two strains of the D. rlieu- 

 maticus corresponded with the 8. fcecalis. 



Beattie 3 also obtained a streptococcus from the synovial mem- 

 brane of cases of acute rheumatism, which regularly produced 

 arthritis, and occasionally endocarditis, in rabbits. Beattie 

 and Yates 4 isolated streptococci from all of thirty-two cases 

 giving definite rheumatic histories, and nineteen out of thirty-one 

 strains tested produced arthritis in rabbits. Goadby has observed 

 similar effects with a streptococcus obtained from the mouth. 



The manner in which typical acute rheumatism generally 

 reacts to salicylates suggests a protozoan organism, if an organism 

 be the cause. 



RHEUMATOID ARTHRITIS (ARTHRITIS DEFORMANS). This 

 disease, which is probably not a single one, may sometimes be 

 caused by an intestinal, urinary, pyorrhceic, or other toxaemia. 



1 Trans, Path. Soc. Lond., vol. Hi, pt. ii, 1901, p. 115. 



2 Lancet, 1900, vol. ii, p. 861, et seq. ; Trans. Path, Soc. Lond., vol. Iv, 

 1904, p. 126. 



3 Journ. Pathol. and Bacterial, vol. xiv, 1910, p. 4.32 



4 Ibid., vol. xvii, 1913, p. 638. 



