ERYSIPELAS 221 



dirty surroundings, and bad ventilation. The disease some- 

 times becomes endemic in a ward, and is expelled with 

 difficulty. It appears at times to exhibit very much more 

 marked powers of infectivity ; it is probably conveyed by 

 air as well as by contagion and by fomites. Artificial im- 

 munity has been produced in rabbits, but the period of 

 protection is short ; when unprotected, the disease is fatal 

 to them in about half the number of cases. 



The probable identity of the Streptococcus erysipelatis 

 and the Streptococcus pyogenes is supported by Jordan, 

 Frankel, and Von Eiselberg (Schenk), Wiirtz, Bokenham, 

 Bulloch and others. 



Semm Treatment. — Antistreptococcic serum was first 

 prepared by Marmormek. This has been used with great 

 success in puerperal fever and other disease conditions due 

 to streptococcic infection. 



The method of preparation has already been dealt with 

 (see p. 134). 



It has been a not uncommon observation by many 

 that an attack of erysipelas supervening upon a malig- 

 nant growth often led to the disappearance of the latter. 

 This fact led to the use of sterilised cultures of the 

 Streptococcus pyogenes in the treatment of inoperable 

 tumours. This treatment has been used with varying 

 success. Coley, of New York, claims to have met with the 

 best success with this remedy, and to have obtained even 

 better results from the use of a filtered culture, containing 

 the mixed metabolic products of the growth of the Strep- 

 tococcus pyogenes and the Bacillus prodigiosus. 



Practical Disinfection. — Care should be taken to ensure 

 thorough cleanliness and proper sanitary conditions of the 

 surroundings, and the attendants should be isolated with 

 their patients. The affected portions should be frequently 

 washed with an antiseptic, as in the case of scarlet-fever. 



