oke" variety. The child goes down
as if struck by an invisible hand; vomiting is one of the first
symptoms; delirium follows within ten or twelve hours; the eruption
becomes not merely scarlet but purplish from hemorrhage under the skin,
giving the name of "black" scarlet fever to this type. The throat
becomes furiously swollen, the urine is absolutely suppressed, the child
goes into convulsions, and dies within forty-eight hours from the
beginning of the attack. Fortunately, this type is rare, but the
important thing to remember is that it may develop in a child who caught
the disease from one of the mildest of all possible cases! Hence every
case should be treated with the strictest isolation, as if it were
itself of the most malignant type.

Naturally, the mortality of scarlet fever varies according to the type.
Not only may it assume a malignant form in individual cases, but whole
epidemics may be of this character, with a mortality of from twenty to
thirty per cent. Generally speaking, however, the death-rate is about
one in twelve, ranging from as low as one in twenty-five to as high as
one in five.

As in the case of diphtheria, the greatest danger and most powerful
means of spread of the disease is through the mild, unrecognized cases,
which are supposed to have nothing but a cold and are allowed to
continue in school or play with other children. We have no antitoxin and
no bacteriologic means of positive diagnosis. But one method will stop
the spread and within ten or fifteen years exterminate every one of
these infections--_isolate at once every child_ that shows symptoms of a
cold, sore throat, or feverishness, both for its own sake and for that
of the community!

In measles we have to deal with a much more harmless and more nearly
domesticated "beast of prey," but one of a prevalence to correspond.
Though probably (exact data being as yet lacking) not more than
one-third of all individuals are attacked by scarlet fever, it would be
safe to say that not more than one-third, and possibly not more than
one-fifth, of us escape measles. Hence, though its mortality is scarcely
one-fourth that of scarlet fever, it more than holds its own in the
Herod class, as grimly shown by its total death-roll of over twelve
thousand, compared with only a little over six thousand to the credit of
scarlet fever.

After the preliminary disturbances of snuffles, hot throat, headache,
and feverishness, which it shares with all