234 DISEASES OF UNKNOWN ETIOLOGY 



inflammations of the heart lining after this disease 

 are frequently streptococcal. 



Impetigo Contagiosa. This is an acute pustular 

 eruption of the skin, thought, but not proven, to be 

 due to the pus cocci. Some observers maintain that a 

 protozoon is the cause. At all events pus cocci, both 

 streptococci and staphylococci, are present. The lesions 

 are at first pustules, but soon break down to flat ulcers. 

 They occur chiefly upon the face. The disease is 

 transmitted by direct intimate contact, such as kissing. 

 Mild antiseptics are sufficient: 1 to 1000 carbolic acid 

 or 1 to 3000 corrosive sublimate. A salve of mercury 

 is usually prescribed. Its importance is greatest in 

 surgical and children's wards and clinics and in schools. 



Noma or Cancrum Oris. This is a perforating ulcera- 

 tion, usually of the cheek, on weak and debilitated 

 children. It is said to be due to a host of different 

 organisms, cocci, pseudodiphtheria bacilli, and many 

 others. The one most frequently found is an anaerobic 

 germ of double appearance, as a rod and as a spiro- 

 chete. The treatment is of a radical surgical charac- 

 ter, as ordinary external applications are unavailing. 

 It is not very contagious, but discharges and sloughs 

 are best burned. 



