584 ELECTIVE LOCALIZATION OF BACTERIA 



pyelonephritis/ and iritis^ studied by me and my co-workers, but he has applied the 

 methods to conditions in which the possibihty of focal infection as having etiological 

 significance has not even been considered by clinicians and pathologists. Thus, in cases 

 of persistent infection around the roots of nails of fingers or toes (perionychia) he has 

 isolated streptococci from tonsils or teeth that localized electively, and produced le- 

 sions around the roots of claws of rabbits following intravenous injection.^ In cases 

 of heart disease the streptococcus cultures from infected teeth produced a high inci- 

 dence of localization in the heart of animals. Haden paid strict attention to technical 

 details and states that the inability of certain observers to obtain corroborative re- 

 sults in this field is attributable to the use of faulty methods. 



Few lines of investigation in medicine have given rise to so much discussion as has 

 the work on elective localization, especially as they pertain to medical and dental 

 practice. That there should be difference of opinion is not surprising. The idea is ap- 

 plicable to a wide range of diseases and calls for radical changes in the concept of their 

 origin. The bacteria, usually streptococci, that proved responsible in many of the dis- 

 eases studied, are, aside from specific infecting power on isolation, much alike. They oc- 

 cur normally on body surfaces and occasionally in normal tissue or as secondary in- 

 vaders to other incitants, and hence extraordinary proof of causal relationship is re- 

 quired. 



The results obtained in a further study of this question, summarized statistically 

 in the tabulation, go far toward fulfilling this requirement. These experiments were 

 performed during the last five years, not so much for the purpose of determining fur- 

 ther the correctness of the elective localization theory as for the purpose of isolating 

 the causative organism from which truly autogenous vaccines might be prepared 

 and used for therapeutic purposes. The methods were essentially alike in the different 

 groups of cases throughout the period of study. Eleven groups of patients suffering 

 from specific diseases and one group having miscellaneous or vague complaints have 

 been studied. The figures indicating the incidence of lesions in the various organs and 

 the incidence of the isolation of the organism injected from the specific lesions or blood 

 are given in percentages and are therefore directly comparable. A higher incidence 

 of lesions in the organs of animals corresponding to the ones affected in patients was 

 found in each of the diseases studied, and thus the results of my previous work are cor- 

 roborated in an additional large number of cases (see Table I). 



While specific invasive or elective localizing power of the streptococci from the dif- 

 ferent diseases studied was high, the general invasive power or virulence was low, the 

 mortality being only 29 per cent of all the animals injected, no higher than in the 

 control group (30 per cent). In agreement with this are the results of cultures made 

 from the specific lesions and blood of the animals injected. The former yielded the 

 organisms in 66 per cent of the animals in which cultures were made, and the latter 

 in only 43 per cent including the animals that died. Rarely was the blood heavily in- 

 fected. Moreover, since patients suffering from the diseases studied rarely die from 

 general infection, these lesions would appear to be directly attributable to the elective 

 localizing power of the streptococci isolated. 



' Haden, R. L.: Am. J. M. Sc, 169, 407. 1925. 

 ^ Haden, R. L.: Arch. Int. Med., 32, 828. 1923. 

 3 Haden, R. L., and Jordan, W. H.: Arch. Dermal. &■ Syph., 8, 31. 1923. 



