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nected with any traceable source of infection, a healthy person
in sequence to a shock, or an injury without cutaneous involvement,
or to a burn, or to some surgical procedure, in the throat
and nose perhaps, or some plastic or other operation, develops
Scarlet Fever. The onset follows the injury or operation
after the usual incubation period, and the disease runs a
typical course.
It is thought that these cases carry the infecting material
of Scarlatina in or on their bodies, that they are Scarlet
Fever carriers, and that they are illustrations of Self Infection.
Under some at present unknown conditions the specific particles
of the disease lie dormant in certain constitutions, and
are innocuous both to their host and to others for periods of
time, but given circumstances favourable to their development
they generate virulent qualities.
Thus take return cases of Scarlet Fever from a Fever
Hospital or private sources, these patients are discharged from
hospital apparently free from infection. Perhaps they have
developed rhinorrhoea or otorrhoea, or some other complication
during their stay in hospital, or other pathological manifestation,
but from which they are quite free on their discharge
from that Institution. Perhaps they have escaped all complications
during their treatment and isolation.
Recent experiences at Beckenham, where medical inspection
of cases returning to their homes from the hospital is
now the custom, indicate that the patients leave there for the
most part without discoverable lesions.
But although patients are released from hospital free
from nasal, ear or other discharges, in certain cases the discharges
recommence or perhaps develop, and then the return
case which was previously harmless, acquires harmful propensities
and Scarlet Fever breaks out once more. The capacity
for infecting others may arise in sequence to an ordinary cold
in the head and have nothing whatever to do with the recurrence
of a specific running from the nose. But in other
instances, perhaps half the number, without signs of desquamation,
eruptions, swelling of the glands, or inflammation of