STREPTOCOCCUS INFECTIONS OF THE TONSILS, THEIR 
DIAGNOSIS AND RELATIONSHIP TO ACUTE 
ARTICULAR RHEUMATISM * 
BY WM. Deb. MACNIDER. 
Perhaps it may seem a rather late day to resurrect such an old 
and well studied subject'as throat infections and their diagnosis. 
The subject has recently aroused much interest in me from having 
to deal with two small epidemics of such cases which proved to be 
of a non-diphtheritic nature and from the complications referable 
to the joints which several of these cases developed. 
Within the past two years I have had the opportunity of study- 
ing fifty-eight infections of the tonsils and adjacent soft ports. 
With but few exceptions these infections have been in males 
between the ages of 16 and 30. Six were in children between 3 
and 8 years of age and four cases occurred in women. 
The acute inflammations of the tonsils are usually due to infec- 
tions by the Staphylococcus or the Bacillus Diphtherise. Some 
organisms of the streptothrix group which are usually present in 
the mouth and which are non -pathogenic, may perhaps under 
favorable circumstances become pathogenic and should be classed 
among the organisms capable of causing acute infections of the 
throat. 
These organisms may be present in pure culture, but frequently 
a mixed infection exists. In such cases a styphylococcus is often 
the organism. It is a large coccus, grows luxuriantly on the 
ordinary culture media add is feebly pathogenic for rabbits when 
they are inoculated subcutneously. 
♦Reprinted from The Charlotte Medical Journal, September, 1908. 
139 
