EDWARD C. ROSENOW 589 



appendicitis, myositis, arthritis, cholecystitis, and ulcer of the stomach usually occur 

 in from one to four weeks after acute infections of the upper respiratory tract have 

 subsided, especially emphasized in appendicitis by Evans,' may, in the light of the ex- 

 perimental findings, be due to the newly acquired elective localizing power of the 

 streptococci responsible for the antecedent respiratory infection. 



The results, both with intravenous and other methods of injection, indicate 

 strongly that the streptococci isolated are the causes of the diseases studied. Their 

 power to localize electively, perhaps more than any other single factor, determines 

 the location of the lesions and, hence, the clinical picture. Elective localization oc- 

 curred, and characteristic changes were produced under experimental conditions like 

 those that pertain to several disease entities. This was possible especially in those in- 

 stances in which intravenous or intracerebral injection of the respective strains re- 

 vealed marked elective localizing power. 



The underlying physico-chemical conditions that determine elective localization 

 of living bacteria are undoubtedly similar to, yet as obscure as, those that determine 

 the specific pharmacodynamic action of drugs and chemicals. However, the fact that 

 certain streptococci possessing elective localizing power, especially those from ulcer 

 of the stomach,^ myositis, epidemic hiccup, and encephalitis, have been shown to pro- 

 duce free poisons or toxins in broth cultures and within the bacterial cell which have 

 the power to injure electively the tissues or organs in which the respective living bac- 

 teria localize and produce lesions throws important light on the problem of how the 

 bacteria overcome the inherent resistance of tissues to invasion. 



' Evans, J. S.: Wisconsin M.J., 17, 91. 1918. 

 ' Rosenow, E. C: J. Infect. Dis., 33, 248. 1923. 



