Cause.—Not definitely known, although thought by Klein and Gordon to be the streptococcus scarlatinae.
Pathology.—The blood is dark, diffluent, and does not coagulate readily, owing to a defect in the fibrin. The eruption disappears after death, except in those malignant cases where the eruption failed to appear during life, and appears upon the death of the patient.
Treatment.—First protect yourself by wearing a bandage of surgical gauze over your mouth and nose, then enter the room of death and wash the body thoroughly with a 1 : 500 solution of bichloride of mercury. Inject an amount of fluid equaling 10% of the body weight into the arteries and inject into the cavities. Drain blood through one of the drainage processes, and add an amount of fluid to the arterial injection equal to that which is lost to the blood bottle. Close all openings with absorbent cotton, dress the body, and then place it in the casket, drawing the glass slide and closing it, after which, it should not be reopened. Abide by the regulations of your district concerning the amount of time to elapse between the time of death and of burial in these cases. For intra-state and inter-state transportation, govern yourself according to the provisions of your district rules.
Variola.
—Synonyms.—Small-pox; German Blattern; French, La Petite Verole.
Definition.—A specific, infectious, highly contagious febrile disease, characterized by a dermatitis, in which the eruption passes from the papule to vesicle, and this in turn into pustule, finally dessicating.
Cause.—The true nature of the virus is not known, and although certain microorganisms have been described which are found in the pock, there is no proof that they are responsible for producing the poison. All that is positively known is, that it is developed in the system and reproduced in the pustule.
Pathology.—The most marked change occurs in the skin, where an eruption takes place, finally with the formation of scabs or crusts. The blood does not reveal any microscopic changes, although darkened in color.
Treatment.—No one but an immune should handle these cases, and he should first wash the body with a 1 : 500 solution of bichloride of mercury. After this has been done, inject an amount of fluid equal to 10 per cent. of the body weight, distributing same by arterial injection. If blood is drained, and it is proper to do so, add fluid to the injection to make up the loss into the blood bottle. Give full cavity injection. Bodies dead of this disease should be buried within a reasonably short length of time, so that the apartments may be rendered safe by fumigation, and under no circumstances should a public funeral be held. After the body has been placed in the casket, the slide, preferably of glass, should be closed and should not be reopened under any circumstances. Govern yourself by the regulations of your district for transportation of these cases.