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W. L. Holman, M.D.
JAMA. 1927;88(6):424-425. doi:10.1001/jama.1927.02680320060033.
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To the Editor:  —A recent article by Allen C. Nickel (The Journal, Oct. 2, 1926, p. 1117) enthusiastically supports the theory of Rosenow on "elective localization." Zinsser, referring to this theory, says: "It is an interesting thought, yet a dangerous one to spread broadcast, since it has influenced clinical thinking to an extent not warranted by experimental fact" (Textbook of Bacteriology, ed. 5, 1923, p. 424). Nickel has confused the issue of elective localization (a theory with little if any experimental basis) with that of secondary infections arising from primary foci, a sequence of events, the main features of which are largely accepted.I fully appreciate the important work Rosenow and his co-workers have done in emphasizing the importance of chronic infected foci in many types of disease, and they are deserving of the highest praise. Although the etiologic significance of the streptococci found in all these cases is not


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