the intense itching. Pitting is generally worse when the scabs are scratched away; children should therefore wear fingerless gloves.
Vaccination. Small-pox is of all diseases the one in which the fact that prevention is better than cure can be most emphatically proved, because we have a means of prevention ready to hand. Vaccination was first practised by Jenner, who noticed that milkmen, whose hands became inoculated with cow-pox in the pursuit of their calling, escaped the scourge of small-pox, so prevalent in those days. Since his day vaccination or inoculation with lymph taken from vesicles, the result of inoculation with calf-lymph, has been practised more and more generally till now it has been made compulsory in most of the countries of the civilized world. Arm to arm vaccination was formerly the custom in this country, but now the law orders that only lymph taken from calves that have been proved to be healthy is to be used. Vaccination undoubtedly protects against small-pox. An infant successfully vaccinated is considered safe against infection for a period of ten years, when he should be re-vaccinated. The operation should be repeated in another seven or eight years' time, and again at similar intervals should there be an epidemic or exposure to infection. A recently successfully vaccinated person never takes small-pox; and one who has been adequately vaccinated in the past, if he should catch the disease, will have it in a very mild form and make an almost certain recovery.
Scarlet Fever, or Scarlatina.—This is an acute febrile disease, producing a scarlet rash upon the skin, attended by a sore throat, and often swelling of various glands, and sometimes followed by dropsy. The disease is most prevalent during the last 3 months of the year, from October to December. The minimum number of cases occur during April. The cause of scarlet fever is principally due to contagion, but there is a considerable mass of evidence to show that cases have arisen from milk derived from cows suffering from an ulcerative disease of the udders (corresponding in the main to scarlet fever), supposed to be scarlet fever in a modified form.
Measles and whooping cough are more contagious; typhus fever and diphtheria are less so. The poison may be retained in clothes for a year or more, and then give rise to fever. Both sexes are equally liable to an attack; between 18 months and five years is the most common time to have the fever. Many people confuse the terms scarlet fever and scarlatina, and imagine the latter is a milder and less dangerous affection; this is a great mistake, for scarlatina is only the Latin name for scarlet fever, and not a different form; the term is too often adopted when there is some doubt as to the nature of the case, and then it is used to conceal ignorance. Scarlet fever may be very mild, or malignant, or latent. The period of incubation is generally less than a week, and may be only 24 hours.
Symptoms.—1. Mild Scarlet Fever.—The onset is sudden; there is
