CYTOLOGIC STUDIES ON RHEUMATIC FEVER: II. Cells of Rheumatic Exudates.

Previously (1), it was shown that rheumatic granulomata are typified by cells which have a characteristic appearance when stained supravitally with neutral red and Janus green (2), and which differ, in their reaction to these dyes, from the typical cells of tuberculous and experimental syphilitic granulomata. The purpose of the present study was to investigate similarly the cells of rheumatic exudates, and to compare the cytologic characteristics with certain clinical features of the disease. It was further proposed to learn whether cells like those of rheumatic granulomata might be found in these exudates and thus serve as a diagnostic aid in questionable cases. Forkner, Shands and Poston (3) and Forkner (4) have reviewed the work done upon the cytologic aspects of synovial fluid prior to the introduction of methods for supravital staining, and have indicated the uncertainty which exists concerning the nature of cells described in those studies because of the limitations of the methods used. Key (5) employed supravital staining in examining cells of synovial fluid of normal rabbits; and similar studies were made on synovial fluid of normal cattle by Bauer and his co-workers (6). Key (7) likewise has described the cells in experimentally induced arthritis of rabbits; and Forkner, Shands and Poston (3) and Shands (8), employed the same technique in studying the synovial fluid in human chronic arthritis. No reports of comparable investigations in rheumatic fever are available.