676 DISEASES OF UNKNOWN ETIOLOGY 



SCARLET FEVER 



(Scarlatina) 



The etiology of scarlet fever, like that of measles, is still obscure. 

 Streptococci have been found with striking regularity in the throats of 

 scarlet-fever patients, and a large number of investigations have seemed 

 to furnish evidence for the etiological relationship of these microorgan- 

 isms with the disease. According to von' Lingelsheim, Crooke as early 

 as 1885 demonstrated the presence of streptococci in the cadavers of 

 scarlet-fever victims. Baginsky and Sommerfeld ' in 1900 examined a 

 number of scarlatina cases with reference especially to streptococcus 

 infection, and reported the presence of streptococci in the heart's 

 blood of eight patients who had died after a very acute and short 

 illness. They expressed the belief that the acuteness of the illness and 

 the rapidity of death in these cases precluded the possibility of the 

 streptococci being merely secondary invaders. A large number of 

 other observers have expressed similar opinions, but we can not, as 

 yet, justly conclude that streptococci are actually the etiological 

 agents in this disease. 



Class ' in 1899 described a diplococcus which he cultivated from a 

 large number of scarlatina patients and with which he was able to pro- 

 duce exanthemata and acute fever in pigs. Subsequent investigations 

 seem to show that Class was really working with a streptococcus. 



Moser,^ working in Escherich's clinic, has recently reported the very 

 favorable influence upon the course of scarlet fever of polyvalent 

 streptococcus antisera. This is not really very strong evidence in favor 

 of the streptococcus etiology of the disease, since there is, of course, no 

 doubt that streptococcus infection complicates the disease, and it is 

 to be expected that antistreptococcus serum should, therefore, benefit 

 the patient's condition by combating this complication. 



Mallory ^ in 1904 published observations on four scarlatina cases on 

 which he bases the belief that scarlatina is caused by protozoa. In 

 the skin, between the epithelial cells, he found small bodies which were 

 easily stained with methylene-blue and which because of their arrange- 



' Baginsky and Sommerfeld, Berl. fclin. Woch., 1900. 



2 Class, Phila. Med. Jour., iii, 1899. 



3 Moser, quoted by Escherich, Wien. klin. Woch., xxiii, 1903. 

 • Mallory, Jour, Med, Research, x, 1904, 



