222 MODERN BIOLOGIC THERAPEUSIS 



Cause The cause of scarlet fever is not 

 known. Klein in 1885 was the first to advocate 

 the streptococcus as the specific cause of scar- 

 let fever. This microorganism is constantly 

 found in the throat of scarlet fever patients and 

 can be isolated from the blood of scarlet fever 

 patients during life and almost constantly after 

 death; and, in the majority of cases of scarlet 

 fever, the cause of the complications and death 

 is the streptococcus. It is probable, however, 

 that the streptococcus plays a secondary role 

 in scarlet fever as it does in smallpox. The 

 disease itself may be due to a protozoan-like 

 body described by Mallory, which lowers the re- 

 sistance of the body to streptococcic invasion. 

 There is good reason to believe as pointed out 

 by Hektoen, Jochmann and others that, al- 

 though the streptococcus is undoubtedly closely 

 associated with the disease, it is the cause of 

 the complicating angina which so often arises, 

 rather than the scarlet fever itself. It is gen- 

 erally accepted that the streptococcus is always 

 associated with scarlet fever, both in the throat 

 and in the septic complications. 



Vaccination Most of the work of vaccina- 

 tion against scarlet fever with Streptococcus 



