Scarlet fever

“ Scarlet-fever and croup and measles are such every-day, red-winged, mottled angels, that no one is appalled at their presence; they take off the little sufferer in such vigorous fashion, clutch him with so hearty a grip, that one is compelled to open the door, let them out, and feel relieved when the exit is made. ”

“ If scarlet fever should appear in a school, the school must for a time be broken up, in order that the disease might be stamped out There must be no half measures where such a fearful disease is in question. A house containing scarlet fever patients should, by parents, be avoided as the plague; it is a folly at any time to put one's head into the lion's mouth! Chloralum and carbolic acid, and chloride of lime, and Condy's fluid, are each and all good disinfectants ”

“ Scarlet fever is eminently infectious. The air which surrounds the patient becomes contaminated and highly charged with the poison, and persons breathing it run great risk of becoming affected. In a case of rheumatic fever, although the secretion from the skin is generally very copious and peculiar in character, so that the sense of smell is strongly appealed to, there is no such risk; the disease can not be conveyed from the patient to those around him, however close the attendance and however defective the ventilation of the room. ”

“ Still, there are conditions for the contagiousness of scarlatina, just as there are for the rarer event of [Pg 733] contagion from the persons of the sick in the plague, yellow fever and cholera. It is a remarkable fact that scarlet fever should ever be sporadic, or that a single case should appear in the midst of a crowded population (as I have seen in a coast town filled with strangers during the herring fishery to the extent of one-half more than its usual numbers) , and no other cases follow for months after, although there had been not the smallest attempt at isolation. ”

“ Under these circumstances, a mode of treatment which promises a decrease in the number of victims, from the experience of a quarter of a [Pg iv] century, and a score of epidemics of different characters, cannot but be received with pleasure by the public. I have treated scarlet-fever hydriatically for twenty-one years, and out of several hundred cases never lost a patient, except one who died of typhus during an epidemy of scarlatina ”

“ THE MALIGNANT FORMS OF SCARLET-FEVER
are caused by the character of the epidemy, but, perhaps, more frequently by the weak and sickly constitution of the patient and the external circumstances affecting it. Thus, persons of scrofulous habit, being naturally of a low organization, without much power of resistance, are much more liable to experience the destructive effects of scarlatina than those whose organism possesses sufficient energy to resist the action of the morbid poison, and to expel it before it can do any serious harm inside the body. ”

“ HOW TO AVOID AND PREVENT SCARLET FEVER. Do not let a child go near a case of scarlet fever. This is especially important to be observed.
Children are in much greater danger of death from scarlet fever than are adults; but adult persons often get and spread the disease, and sometimes die from it. Mild cases in adults may cause fatal cases among children. Unless your services are needed keep away from the disease yourself. If you do visit a case, bathe yourself and change and disinfect your clothing and hair, beard, if any, and hands before you go where there is a child. ”

“ The scarlet fever exists with all degrees of virulence, from a flea-bite to the plague. The infectious material of this disease, like that of the small-pox, I suppose to be diffused, not dissolved, in the air; on which account I suspect, that it requires a much nearer approach to the sick, for a well person to receive the infection, than in the measles; the contagion of which I believe to be more volatile, or diffusible in the atmosphere. But as the contagious miasmata of small-pox and scarlet fever are supposed to be more fixed, they may remain for a longer time in clothes or furniture ”

“ Murchison collected the statistics of deaths from scarlet fever in England and Wales during a series of years ending with 1861. The number of deaths aggregated 148,829, and the percentage of deaths at different ages was as follows:
Among the deaths were ten cases above the age of eighty-five years, so that scarlet fever, though especially a disease of childhood, may occur in any decade of life; but old age, like early infancy, almost possesses immunity from it. ”

“ The more violent the contagious poison, and the weaker the organic power, the less decidedly and the less successfully will the organism combat against the poison, and the more inroad will the latter make upon the system, affecting vital organs and paralyzing the efforts of the nervous system by attacking it in its centres. In such cases of torpid reaction, the patient frequently passes at once into a typhoid state. This is what we call scarlatina maligna, or malignant scarlet-fever. ”

“ It is unfortunate that a very slight resemblance of some of its symptoms to those of scarlet fever has led to its being sometimes mistaken for it, and as the ailment is almost always very trivial, doctors anxious to avoid alarming their patients' friends, too often allow the error to go unrectified, and the disease to pass as one of mild scarlet fever. ”

“ He reports that compulsory notification has not only lowered the mortality of scarlet fever, but actually modified its type, so much so that it is now difficult to tell when one has or has not to deal with the suspected disorder. On every side one hears it repeated that epidemics are now characterized by a want of symptoms and signs. ”

“ Scarlet fever and measles are both blood poisons, each one being perfectly separate and distinct from the other. "Hybrid" Scarlet fever is, in my opinion, an utter impossibility. In olden times, when the symptoms of diseases were not so well and carefully distinguished as now, scarlet fever and measles were constantly confounded one with the other, and was frequently said to be "hybrid"—a cross between measles and scarlet fever—to the patient's great detriment and danger, the two diseases being as distinct and separate as their treatment-and management ought to be. ”

“ Scarlet fever was a very much more dreadful disease when I was a child than it is now-a-days. Not only have methods of treatment improved greatly, but the disease itself is not so deadly, or perhaps man’s resisting powers have increased. It is a pity that diseases like everything else do not grow old and weak and lose their power to destroy. ”

“ Period of Development.—After exposure to the germs of scarlet fever, usually from two to five days elapse before the disease shows itself. Occasionally the outbreak of the disease occurs within twenty-four hours of exposure, and rarely is delayed for a week or ten days.
Symptoms.—The onset is usually sudden. It begins with vomiting (in very young children sometimes convulsions) , sore throat, fever, chilliness, and headache. The tongue is furred. The patient is often stupid; or may be restless and delirious. ”

“ Its mortality in the London bills is added to the general febrile heap. This contagious epidemick is most frequent in the infant and adolescent age; it attacks families and schools about one time; and the same person but once in life; and is said to be most frequent in winter. It is generally accompanied with an anginous or ulcerous sore throat, but not putrid. That genus or species of scarlet fever which usually accompanies angina gangrenosa,{114} and is extremely dangerous, is hereafter described. The symptoms of simple scarlet are the usual febrile precursors ”

“ Malignant Scarlet Fever—is characterized by an increased severity of the above symptoms; there are great prostration, delirium and sleeplessness; the rash does not always come out well; the face may be livid, and stupor and coma come on and end in death; the throat is ulcerated, and there is much difficulty in swallowing.
3. Latent Scarlet Fever—is when the disease is so mild that until the sequelae appear one is not aware of having had scarlet fever. Sore throat may be the only symptom. There is no relation between the abundance of the rash and the danger to the patient. ”

“ It has not yet, so far as I am aware, been shown that scarlet fever is milder in any animal than in man, nor, if we admit that it is modified in the animal, is it certain that the disease could be returned to man in the modified form. ”

“ During recent years the type of scarlet fever has become greatly attenuated, and this constitutes one of the difficulties of prevention, as the mild form of the disease is apt to be overlooked. The fatality per 100 persons attacked varies greatly with age. It is highest in children under four, rapidly declining with increasing age. Hence the importance of protecting children from attack in early life. Two results follow from the wise precautions taken to prevent attack early in life. (a) With each successive year of life the liability to attack, when exposed to infection, diminishes ”

“ GRAVE FORM (malignant scarlet fever) .—This form of the disease is in some epidemics common, while in others it is rare. The symptoms which characterize it are severe from the beginning, those of the nervous system predominating at first, such as intense cephalalgia, restlessness or stupor, sudden twitching of the muscles, and perhaps delirium, or even convulsions. Many pass rapidly into coma and die within two or three days, succumbing to the intensity of the scarlatinous poison while the malady is still in its commencement. The rash is dusky. ”

“ All we know is that no organ seems to be exempt from its sudden return attack long after the disease has passed. If we ever get any complete records, I venture to say that we’ll find more children dying in after years from the results of scarlet fever than die from the immediate disease itself, not to mention such after-effects as deafness and blindness.”
“I’ve noticed that,” said Grandma Sharpless, “when we lived in the country. And I remember a verse on the scarlet-fever page of an old almanac:—
If they run from nose or ear,
Watch your children for a year. ”

“ Most persons, it is true, realize that scarlet fever is serious; everyone should also realize that measles and whooping-cough are serious. For example, in the State of New York during the year 1916, more children died from each of these diseases than from scarlet fever: in that year 745, or four times the number that died of scarlet fever, lost their lives from whooping-cough, while 913 died of measles. If diseases that kill hundreds of children every year are not serious, one is at a loss to know what a serious disease is. ”

“ A case of scarlet fever never gives rise to small-pox in those exposed to infection, neither does any one of the above diseases ever pass into another. There are other subordinate distinctions: the poison of scarlet fever, contained presumably in detached particles of skin, clings for months to articles of clothing, especially woolen ones; that of small-pox may be collected from the eruption and preserved for years between pieces of glass; that of typhus is easily rendered innocuous by free ventilation. ”

“ All the symptoms become worse, and for ten or twelve days the patient is very ill. After this period, in favorable cases, a change takes place for the better, the rash dies away, and all the other symptoms gradually subside. In from four to six weeks, supposing that there are no complications, the patient regards himself as well. Such, in a few words, is the course of a mild case of scarlet fever, which may be considered as a typically infectious disease. Now suppose that our patient is treated in a house where there are several other young people who have never suffered from the disease. ”

“ In view of the alarming prevalence of scarlet fever in many parts of the country, the following hints by the British Medical Journal are wholesome warnings: "There are three common ways by means of which infectious diseases may be very widely spread. It is a very usual practice for parents to take children suffering from scarlet fever, measles, etc., to a public dispensary, in order to obtain advice and medicines. It is little less than crime to expose, in the streets of a town and in the crowded waiting room of a dispensary, children afflicted with such complaints. ”

“ The mortality from scarlet fever, in fact, exceeds the mortality from small-pox and measles taken together. Scarlet fever is known to prevail over the whole of the continents of Europe and America, but it is nowhere so common as in Britain. In France it is a rarer disease than either measles or small-pox. In India it is said never to occur. In most instances it is not difficult to trace the occurrence of scarlet fever to contagion ”

“ Scarlet fever is probably a germ disease, and the germs may live for weeks in toys, books, letters, clothing, wall paper, etc. Close contact with the patient, or with objects which have come in close touch with the patient, is apparently necessary for contagion. ”

“ All the efforts of medical men to stop the ravages of Scarlet-Fever have hitherto proved unavailing; every remedy which was considered, for a while, a specific proved subsequently inefficient; and, notwithstanding the assertion to the contrary of a few, the Dr. Jenner who shall discover a reliable prophylactic against scarlatina, is probably not yet born. The patients die in the same proportion as they did two hundred and fifty years ago, and the physicians who have any success at all in the treatment of the terrible scourge, are those who treat for symptoms and leave the disease to Nature. ”