736 



INFECTION AND IMMUNITY. 



Secondary 

 Infections. 



Distribution the body aside from its occurrence in the skin and 



of Virus in , -^r , , , . , 



Body, mucous membranes. We may feel certain, how- 

 ever, that the infection is systemic. The lesions 

 of the skin are of such a nature that they are 

 generally regarded as of embolic character, which 

 presupposes blood infection; and transmission of 

 the disease through the placenta is decisive proof 

 of a general distribution of the virus at some stage 

 of the process. The failure to cause vaccinia in 

 the cornea of the rabbit by inoculating the blood 

 of patients (cited above) may indicate that the 

 virus is present in the blood in small quantity or 

 that circulating organisms are eventually de- 

 stroyed. The intoxication of smallpox is mani- 

 festly general. 



In few diseases does secondary infection play so 

 important a role as in smallpox. When the cu- 

 taneous lesions have become pustular they usually 

 contain pyogenic cocci, although they may be ab- 

 sent. It is somewhat strange that streptococci are 

 more often encountered than staphylococci, in 

 view of the normal presence of the latter in the 

 epidermis. Fatal cases are almost without excep- 

 tion accompanied by general streptococcus infec- 

 tions, and Councilman believes these organisms 

 are more important as a cause of death than the 

 specific virus. 



prophylaxis. Successful prophylaxis involves universal vac- 

 cination, in addition to special measures which are 

 demanded in the presence of the disease: isola- 

 tion of the sick until desquamation is complete, 

 antiseptic baths, and disinfection and fumigation 

 as currently practiced. 



Interesting matters of history are the facts that 

 protective inoculation against smallpox was prac- 



