Researches on rheumatism / by F.J. Poynton and Alexander Paine.

Date:
1913
Catalogue details

Licence: In copyright

Credit: Researches on rheumatism / by F.J. Poynton and Alexander Paine. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    been made by the patient, who was no doubt suffering far more from abdominal pain. Mr. Raymond Johnson operated at once and removed a large and swollen appendix covered with fibrino-plastic exudation. There was neither gangrene nor perforation, and there was no concretion. The patient made an uninterrupted recovery. There was no previous history of any serious illness. 2. The Investigation While under the anaesthetic a culture was taken from the right tonsil, and the appendix was placed in a sterile tube. (a) The bouillon culture from the throat showed mainly strepto-diplococci, but also a few staphylococci and an occasional bacillus. There was no difficulty in isolating the diplococcus from the culture. (b) Cultures from the appendix made by smearing the exudate upon agar showed mainly the bacillus coli, but also some colonies of strepto-diplococci. (c) Cultures from the sanious fluid which had exuded from the appendix after it had remained a few hours in the sterile tube at room temperature, and which had been then withdrawn and incubated in a Pasteur pipette, gave a pure culture of strepto-diplococci. (d) Some of the sanious fluid inoculated upon agar and into bouillon showed strepto-diplococci, but a predominance of the bacillus coli. These results with the sanious fluid are of interest because they bear out our experience that in media such as bouillon, devoid of immune factors, the more saprophytic coli organisms rapidly get the upper hand, but in the blood serum the more pathogenic organism grows the more readily. This point as to the importance of serum Kretz had already dwelt upon in his paper.2 The diplococci from the throat and from the sanious fluid ap- peared to us morphologically and in cultural characters identical. A. Experimental results with the culture from the throat. The diplococcus produced arthritis with the usual accompanying symptoms in the rabbits intravenously inoculated and was again recovered in pure culture from the arthritic exudations. Later investigations have resulted in the production of malignant endocarditis with infarctions in the spleen and kidneys.
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