Acute rheumatic fever and its etiology / by W.V. Shaw.

  • Shaw, W. Vernon (William Vernon)
Date:
[1903?]
Catalogue details

Licence: Public Domain Mark

Credit: Acute rheumatic fever and its etiology / by W.V. Shaw. Source: Wellcome Collection.

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    the injection both knee-joints were swollen and tender, and in forty-eight hours the elbow- and carpal-joints were also involved. The monkey was now extremely ill and unable to feed itself. It was kept alive for another twenty- four hours by feeding it with brandy and milk, but during this time it had very obvious dyspnoea. It died just three days after the injection with Dr. Poynton’s micrococcus. A careful post-mortem examination was carried out. The pericardium was thickened, and contained a considerable quantity of turbid, sero-fibrinous exudation, in which were floating flakes of lymph. The visceral pericardium was dull and covered with flakes of fibrinous exudation. The heart itself was dilated, and the heart muscle pale and flabby. The endo¬ cardium was inflamed, with recent exudation in the mitral valve flaps, and a distinct beading of the free edges. Both knee-joints were distended with fibrinous exudation, which was thick and glairy in appearance. There was similar exudation into the carpal- and elbow-joints. In the lungs there were a few patches of consolidation. The spleen was enlarged, and there were a few small haemorrhagic infarcts in the kidneys. Cultures were taken from the heart’s blood, right and left knee-joints, and pericardial exudation. All the cultures proved positive, yielding pure growths of the micrococcus. This monkey then had arthritis, pericarditis, myocarditis, and endocarditis, all caused by the micrococcus. These lesions are clini¬ cally associated with an attack of acute rheumatism. Indeed, the phenomena exhibited by this monkey during the fatal illness were in every way similar to those of acute rheumatism in man. Monkey 2.—This monkey was inoculated intravenously on three separate occasions. The first two only caused transitory illnesses. After an interval of one month the monkey was injected with cultures of the micrococcus obtained by Dr. Poynton from a case of acute rheumatism, at the Hospital for Sick Children. The same evening the monkey was ill and feverish. The next day it was worse, and unable to use its legs. In the evening the knee-joints were swollen, hot, and tender. The animal was also feverish and thirsty, and showed a dislike for solid food. On the following day the elbow- and carpal- joints were affected. The monkey was unable to use its hands. The knees also were still swollen and painful. On the fourth day the animal was better and more lively, but the joints were still swollen. On auscultation over the prsecordium a distinct systolic murmur wms heard, especially close to the left nipple. This murmur was never detected in the healthy animal. This monkey is still alive. The joints are slowly recovering, and the swelling decreasing. Those who saw the monkey in the different stages of the acute illness were unanimous in the opinion that it bore a close, unmistak¬ able resemblance to a case of acute rheumatic fever, as seen in children. Microscopical Examination of the Tissues of the Infected Animals. 1. Exudation into joints.—Thin films were made of the exudation after the manner of blood films. These were simultaneously fixed and stained by the L. L. Jenner modification of Romanowsky’s eosinate of methylene-blue. The micrococcus was found in all the films examined, being stained a purple-blue. It occurred in short chains sometimes as a diplococcus, but more often as a streptococcus. The specific micro-organism was present in by far the larger numbers in the exudation from joints in the early or acute stage. In such