A NEW CONCEPTION OF THE CAUSE OF SCARLET FEVER AND THE OTHER ACUTE EXANTHEMS

To the Editor:  —In 1895, Bergé ("La pathogénie de la scarlatine," Paris) said, in regard to the cause of scarlet fever, "An imposing array of evidence points to the streptococcus in one of its virulent forms as the pathogenic agent of the disease." Time and further experimental work have served only to strengthen this belief in the minds of many investigators.It is generally assumed that the chief portal of entry for the causative agent in scarlet fever is the upper respiratory tract, more particularly the throat and tonsils. However, the many apparently typical cases of scarlet fever developing shortly after childbirth, severe burns, wounds and surgical operations suggest the fact that the causative agent may also find extrafaucial portals of entry. For many years we have been aware of the relation between complicating streptococcus infection and childbirth, burns, wounds and surgical operations.How is it possible for the same