The component of Group A streptococci which is responsible for the chronic, remittent, multinodular lesion of connective tissue is derived from the cell wall. Further evidence is given to support the essential role of the group-specific C polysaccharide in the production of this lesion.

A series of particles containing the group-specific C polysaccharide was prepared, ranging in size from large cell wall fragments to the relatively small hapten. A comparison of the lesion producing capacity of the particles in this spectrum revealed that maximum toxic activity is associated with C polysaccharide complexes of intermediate size. The discussion considers colloidal properties associated with C polysaccharide complexes of a certain size, and the influence particle size has on persistence in tissue, as possible explanations of the relationship between the size of the C polysaccharide complex and its ability to produce the chronic lesion of connective tissue.

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