STREPTOCOCCUS INFECTIONS 107 



transmission is probably always direct, and that infec- 

 tion through the air is very unlikely. For this reason, 

 it is unreasonable to insist on isolating cases of erysipelas 

 while keeping cases of puerperal sepsis in the ward. 

 In fact, so long as the skin remains unbroken in the 

 former condition, there is not much likelihood of trans- 

 mission to others. The most virulent streptococci are 

 those coming immediately from septic infections. 

 Owing to the extreme susceptibility of women directly 

 after childbirth to infection by way of the inner raw 

 surface of the uterus, it is imperative that no nurse who 

 has just before been in contact with streptococcus in- 

 fections, or even with pus of any kind, be allowed to care 

 for obstetric cases. 



An antistreptococcus serum, obtained by injecting 

 horses repeatedly with various cultures of Streptococcus 

 pyogenes, has been used in the treatment of streptococcus 

 infections. The results, as reported by different ob- 

 servers, are variable, but in certain cases appear to be 

 good. The dose of the serum is large, from 50 to 100 c.c. 

 or more intravenously, is usually recommended. Moser, 

 of Vienna, uses the serum extensively in the treatment of 

 severe cases of scarlet fever, and claims good results. 

 The treatment of streptococcus infections by means of 

 bacterial vaccines has yielded rather favorable results 

 in the hands of some observers. 



Years ago it was noted that malignant tumors some- 

 times tended to disappear or at least improve in 

 persons who had recovered from accidental erysipelas. 

 This led to the artificial production of erysipelas in such 

 cases by the inoculation of pure cultures of streptococcus. 

 Later on, only their toxic products were employed. 



