ACUTE RHEUMATISM 565 



PYORRHCEA ALVEOLARIS (Rigg's disease). Goadby 1 has found 

 the following organisms to be probably causative in this disease : 

 M. citreus granulatus, M. pyogenes, var. aureus, streptococci, M. 

 catarrhalis, and diphtheroid bacilli, and has used vaccine treatment 

 with success. Eyre and Payne 2 have found similar organisms, 



RAT-BITE DISEASE. A disease occasionally met with in England 

 but commoner in Japan, and consequent on the bite of a rat. It 

 is characterised by weekly bouts of severe fever lasting two or three 

 days. No organism has been detected. 3 



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, 

 and Singer regards the disease as merely an attenuated form of 

 pyaemia. Menzer considers that rheumatic fever is not due to any 

 one organism, but is a particular reaction in predisposed 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 (enteri- 

 tidis sporogenes), and is believed by the writer 4 to be identical with 

 the latter ; it is probably a terminal infection or a contamination. 

 Poynton and Paine 5 in 1899 obtained from eight successive cases 

 a diplococcus (D. rheumaticus) which in broth develops into a 

 streptococcus. Injected intravenously into rabbits the diplococcus 

 frequently produces enlargement and inflammation of the joints 

 with effusion, and occasionally valvulitis and endocarditis. In 

 man the organism was demonstrated in the vegetations, pericardium, 

 tonsils, and rheumatic nodules, and has been isolated from the 

 blood, pericardial fluid, cardiac vegetations, and tonsils. 



Andrewes and Horder found that two strains of the D. rheumaticus 

 corresponded with the S. fcecalis (p. 234). 



Beattie 6 also obtained a streptococcus from the synovial mem- 

 brane of cases of acute rheumatism, which regularly produced 

 arthritis, and occasionally endocarditis, in rabbits. Goadby has 

 observed similar effects with a streptococcus obtained from the 

 mouth. 



The manner in which typical acute rheumatism generally reacts 



Proc. Eoy. Soc. Med., February 1910 (Odontological Section). 

 Ibid. December 1909. 



See Hewlett and Rodman, Practitioner, July 1913, p. 86. 

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

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

 1904, p. 126. 



6 Journ. Pathol. and Bacteriol., vol. xiv, 1910, p. 432. 



