Abstract
This contribution is based on a series of observations made on infants suffering from acute otitis accompanied by marked systemic disturbances. All the patients have been studied in connection with the pediatrician. The observations made are my own judgments based on a personal study of the conditions. None of the conclusions are necessarily final, but they are interesting and important, and perhaps may contribute a little to the management of this difficult condition. LITERATURE In 1894, Hartmann1 mentioned intestinal disturbances in otitis media in infants. Ponfick and Hartman noted that intestinal disturbances improved after paracentesis. They thought that intestinal disturbances were due to streptococci growing in the middle ear. In 1897, Ponfick2 discussed the relationship between acute otitis and intestinal disturbances in infants. In thirty-eight cases of chronic enteritis, thirty-three patients had involvement of the middle ear. In 1896, Simmons3 spoke of finding lesions of the kidney

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