Abstract
In human patients subacute streptococcus endocarditis is a fatal disease. No authentic report of a recovery has even been published. The mechanism of production of this disease in human beings displays two constant factors—injury to the valve and later infection. The injury is usually represented by either congenital valvular heart disease or rheumatic valvular heart disease. The later implantation of green streptococcus on this injury usually takes place through the medium of an infection of the middle ear or throat or some other locality where green streptococci normally breed. In experimental work Rosenbach recognized these two factors in 1878 and reproduced infection in the heart valve after puncture of the valve. Although a beginning was made so long ago, and more perfect instruments have been devised for injuring the valve, no attempt has been made to reproduce the disease completely and glomerular nephritis of the type which characterizes the disease in human beings has never heretofore been reproduced. All clinical efforts to obtain a cure of the disease have failed. It seems, therefore, that we must have the disease reproduced in animals and then thoroughly study its features if we are to expect a cure.
This work consists in injuring the aortic valve by inserting an appropriate instrument into the left carotid and then, after recovery, the animal is infected by intravenous inoculation of green streptococcus. The inoculated bacteria become implanted at the site of the valve injury and there set up a bacterial vegetation identical with that of human patients. Dogs were used in these experiments. Dogs living 12, 13 and 14 days failed to show any kidney Iesion of the glornerular type although large infractions were common.
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