746 INFECTION AND IMMUNITY. 



septic baths or ointments, or vigorous scrubbing 

 with soap as desquamation proceeds; antiseptic 

 treatment of the mouth cavity; disinfection of all 

 utensils, linen, etc., with which the patient has 

 been in contact ; avoidance of stirring up the dust 

 in the room, which demands moist rather than dry 

 cleansing; the disinfection of the sputum and 

 other discharges of the patient; an abundance of 

 fresh air and sunshine in the sick room; the final 

 disinfection of the room. Physicians and nurses, 

 when in the presence of the patient, should wear 

 long gowns, which can be discarded on leaving, 

 and other well-known precautions should be ob- 

 served to avoid spreading of the disease. The pro- 

 phylactic vaccination by means of streptococcus 

 (Gabritchewsky) is deserving of further trial. 



Scarlet fever is particularly a disease of child- 

 hood, "a large proportion of cases occurring before 

 the tenth year" (Osier). Adults are attacked not 

 infrequently. Infants are less susceptible than 

 older children. Many examples of family immun- 

 ity, which probably is relative, are encountered, 

 and likewise instances in which there is a family 

 susceptibility. In a given family examples of in- 

 dividual immunity and susceptibility are fre- 

 quently met with. One attack usually confers im- 

 munity against a second, but not invariably. 

 Leucocytes. Scarlatina is characterized by a leucocytosis, 

 the degree of which bears some relation to the 

 severity of the infection. In mild cases the aver- 

 age is from 10,000 to 18,850 (Bowie), in moder- 

 ately severe cases from 20,000 to 40,000, or even as 

 high as 78,000 (Klotz) ; in malignant uncompli- 

 cated cases there is a tendency to a low leucocyte- 



