THE BACTERIOLOGY OF RHEUMATIC FEVER AND THE ALLERGIC HYPOTHESIS

Abstract

Evidence of the association of the nonhemolytic streptococci with rheumatic fever has recently been much strengthened by the work of Small¹ and of Birkhaug.² Their studies have given added importance to the earlier work of Rosenow,³ Rothschild and Thalheimer,⁴ of Davis⁵ and of many others who have isolated organisms of this group from cases. Small and Birkhaug obtained organisms to which they attribute specific etiologic significance, and, in keeping with many others who have announced similar results, believe that the lesions of the disease remote from the localization of the bacteria are caused by the absorption of toxins. As opposed to this school of reasoning there has gradually developed another view, namely, that many of the manifestations of rheumatic fever are due to an allergic reaction of sensitized tissues to the antigenic materials discharged from chronic streptococcus foci; a theory which is more reconcilable with the experience that the organisms