380 PHARMACEUTICAL BACTERIOLOGY . 



to subsequent attacks but such acquired immunity is not by any means 

 permanent. The anti-pneumococcic serum is used with some apparent 

 success though the results are far from satisfying to the majority of those 

 who have tried it. Dr. Shafer has recently recommended a mixed bac- 

 terin (composed of disease exudate and pure pneumococcic bacterin) which 

 has been used with some success. At the present time the use of the 

 specific bacterin (ordinary and sensitized) is much used as a cure, employing 

 the polyvalent bacterin in those cases where diagnosis is uncertain, and 

 in cases where it is not convenient or possible to make the differential 

 tests. Three differential tests are recommended, the urine test, the 

 sputum test and the exudate test. Confirmatory cultural tests and micro- 

 scopical examinations are also made. The details of the differential as 

 weU as the confirmatory tests cannot be given here. They may be found 

 in the larger more comprehensive manuals of medical bacteriology. 



It is important to guard against exposure to wet and cold, particularly 

 when the vitahty of the body is lowered, as through lack of sleep, lack of 

 food, over-exertion, etc. The sputa of patients should be disinfected at 

 once. Well persons having good resisting power may carry the germs 

 and convey the disease to those who have a lower vitality. The room 

 occupied by the patient should be thoroughly fumigated as soon as possible. 



D. Small-pox. — Also known as variola and pest. This is a well- 

 known disease which has occurred epidemically from time to time through^ 

 out all ages and in all lands. It is most highly infectious and contagious. 

 In spite of all investigations, the primary cause has not yet been discovered. 

 The contagion is wafted from the skin eruptions and is carried in clothing 

 and by everything used or touched by the patient. The contagion may 

 lie dormant in clothing for months. The contagion is known to be 

 filterable, will remain active in glycerin for months, will resist drying for 

 weeks but is quickly rendered inert by bile and by sodium oleate. Heat- 

 ing for 15 minutes at a temperature of 58° C. will also destroy it. Certain 

 cell inclusions (infected epithelial cells) have been considered the primary 

 causative organisms, and have been named Cytoryctes vaccinae. These 

 are very minute but may readily be seen in the epithehal debris of the 

 vaccine. 



All excreta from the patient should be disinfected with a 5 per cent, 

 solution of carbolic acid or other convenient disinfecting agents as Ume, 

 formahn, etc. Bedding, mattresses and other material used in the sick- 

 room should be burned as soon as the patient does not need them any 

 longer. 



As the result of the general practice of vaccination (with the modified 

 cow virus) small-pox is no longer the dread disease that it once was. 

 In Germany, where smallpox vaccination has been religiously enforced 



