Experiments Leading to a Possible Basis for Vaccine Therapy in Acute Rheumatic Fever.

Abstract

The experiments and observations of Swift' and Birkhauf showed that there is marked similarity in the hypersensitiveness (allergy) to streptococci in animals made hypersensitive experi-mentaIly and in patients having acute rheumatic fever.With this similarity in mind we have carried on a series of experiments in animals to determine bhe relation ,between hypersensitiveness and the concentration of antibodies in the blood.Rabbits were made hypersensitive to streptococci according to Swift's method by injecting 5 cc. of agar heavily seeded with streptococci into the subcutaneous tissue in one area. In from 12 to 15 days these rabbits were injected subcutaneously with I/IW of a standard amount of streptococci in each of 10 places on the right side and with 1/10oo of the amount in each of 10 places on the left side. The character, number, and size of these nodules were used as an indicator of the degree of hypersensitiveness of the animals. Some of these hypersensitive animals were injected intravenously with streptococci from 3 to 5 days before the multiple subcutaneous injections were made. The serum of the animals was tested for agglutinins at the time of the multiple subcutaneous injections and 5 days later when the animals were killed and the nodules examined. I. In the hypersensitive animals gross lesions, often large abscesses, were frequently seen. 2. The humoral immunity as indicated by agglutinins was relatively low. 3. Giving an intravenous injection of streptococci to these hypersensitive animals, in from 3 to 5 days before the multiple subcutaneous injections in the back, prevented the development of subcutaneous nodules. 4. These desensitized animals showed a high humoral immunity as indicated by a high agglutinating titer. 5.The high humoral immunity appeared to be the factor which prevented the development of subcutaneous nodules.The fact that hypersensitiveness in rabbits injected with strepto-The following facts were observed:

Diverticulum of the Epiglottic Valleculae

“…Clinically they are characterized by a feeling of a lump in the throat after eating, with discomfort on swallowing, occasional régurgitation of foul material, swelling in the submaxillary region, and local tender¬ ness, with no laryngologic changes. 4. Fluoroscopically the condition can be definitely diagnosed, especially if the observation is prolonged.…”

“…4 Another explanation for the pre-epiglottic retention of food was brought forward by Holzknecht and Olbert.5 In certain evidently neuropathic persons in whom fluoroscopy revealed marked stagnation of food along the anterior surface of the epiglottis and in the valleculae, they found an unusual relaxation of the entire esophagus. The retention was explained on the basis of atony.…”