SCARLET FEVER. Synonyms.—Scarlatina; Scarlet Rash. Definition ...

formed a topic for innumerable journal articles; and yet,
notwithstanding these facts, and the great advance made in sanitary
methods, there are more deaths recorded to-day from diphtheria than
from any other contagious disease. The disease has prevailed in this
country ever since its first appearance in Boston, 1638.
Etiology.—The disease usually prevails epidemically, though in all
large cities it is endemic. The force of the contagion varies in different
epidemics; but, taken as a whole, I am inclined to believe that it is less
contagious than scarlet fever. The last thirty years has witnessed
greater search for the causal agent than all previous years combined.
Dr. Pruden and others, after careful investigation in a series of cases,
came to the conclusion that a streptococcus, which is always present in
the membranous exudate, was the causal agent. Dr. W. W. Taylor
presented to the London Epidemiological Society the history of a
number of cases, to prove that common mold was the causal agent.
Others have tried to prove that sewer-gas was a prime factor in
producing the disease. Each investigator showed an array of cases to
prove his position, yet each and all fail to prove that every case can be
traced to the causal agent.
Since 1868, when Oertel discovered micrococci in the pseudo-membrane,
bacteriologists have been trying to separate the special bacillus which
will invariably produce the disease. While it might be interesting to
some to trace the work of such investigators as Oertel, Cohn, Klebs,
Loemer, Roux, Yersin, and a host of others, space forbids. Suffice it to
say that from out of the great mass of investigations there has been
evolved the Klebs-Loeffler bacillus as the causal agent. This is the
generally accepted micro-organism which is responsible for diphtheria.
Yet there is ground for much difference of opinion as to the reliability of
this germ as the causal agent. First, it is found in other diseases of the
mouth and pharynx. Again, it is sometimes found in the healthy mouth
and the mucous surfaces of the throat and nose, and finally it is
sometimes absent in well-known cases of diphtheria; but in order to
prove that this special bacillus is the cause, all cases showing an
absence of this germ are denominated false diphtheria, or diphtheroid
angina. Hence we divide the bacilli into two classes,—the Klebs-Loeffler
bacillus of true diphtheria, and Hoffman's bacillus, or the pseudo
diphtheria bacillus, or bacillus xerosis. (See frontispiece.)
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 152