HEALTH NOTES

New Zealand Mail, Issue 1675, 6 April 1904, Page 58

HEALTH NOTES

(By Dr Andrew Wilson.)

SCARLET FEVER.

'As scarlet fever is a disease apt to be prominent, it may be useful to mothers if the chairacteriistia symptoms of ‘ this fever be described, and if further hints ' be given regarding its treatment, and _ especially with reference to the avoidance of infection spreading to other and healthy children. If we notify the pro'gress of scarlet fever during the year by means of a curve we find that this fever tends to be much less prevalent during the first eight months of the year than during the succeeding four months. The curve begins to rise in September, and reaches its height in October and November, In December it is also high,, font appears to fall! after that period, so - that the end of the year begins with a less tendency to the development of the disease. That scarlet fever is caused by the spread and multiplication of a particular kind of microbe or germ in otur bodies goes without saying. In all its ways and symptoms this ailment' exhibits the characteristics of a germ-pro-duced; affection. In the first place, it is highly infectious. In the next, 'it- has a period of incubation or hatching, as it were. Third, it comes to a head, then declines as all fevers do, and the germs Produced in the patient’s body are capwhen conveyed to healthy persons of infecting them. Un all of these grounds we may therefore rest well assured that scarlet fever is a germ-pro-duced ailment. MODE OF INFECTION. [ make these remarks for the purpose >f impressing these primary facts .on my readers, and also for the. reason that tho particular germ to the attack of which scarlet fever is due is as yet. Unknown. It is not difficult to understand. why we are yet ignorant of the ®xact nature of this microbe. When oases of scarlet fever are examined by way of detecting the germ to which the ailment is due, it is found that a large number of microbes are included in what wo may call the scientific man’s bag. - TTis great difficulty in this case is particularly that of separating out from tho mass of germs thus acquired 1 the exact mjicrobe to which the fever is due. The process of discovering the special germ is a long and tedious one, involving an limmrenso amount of work in the laboratory, the cultivation of many species of germs, and finally the determining, always a difficult point, of the. particular microbe which is responsible for the fever. There is no doubt that in the vast majority of cases scarlet fever is .conveyed 1 to us by means of milk which has been infected by the germ. iWha.t adds somewhat to the complicated nature of this disease in respect of our tracing out its exact origin is the circumstance that it is an undoubted fact that the chw may suffer occasionally from an ailment which appears to represent scariest fever in that animal. In such a case (represented by a remaa'kable epidemic in L-ondon in 1886) the disease of the cow. undoubtedly affecting her milk is thus conveyed to human ings. In the vast majority, of cases, however, milk is contaminated not by the Cow, bub by human beings suffering ' from 'the disease. Hence we see the extreme importance of the regular inspection not merely of dairy farms, but of shops where milk is sold. One extrejmieliy interesting and all-important point involved in this consideration is that which teaches us that occasionally we meet with extremely mild cases of the disease. These are oases in which the patient is very slightly affected, and may not require to take to bed .at all. Nevertheless there is found on exami notion a suspicious sore throat, whilst when theßtage of better ness arrives the peeling off of the skin, so. marked in ordinary oases, may bei represented by a, mere slight scurf typically found between the fingers. Mild as- these oases are they are nevertheless capable of conveying the disease to other parsons, and if we suppose the case of any person, who handles milk being thus infected, and the occurrence of the disease being practically unsuspected, it is clear how an apildemic of ases may _ thus be set up. Each household receiving milk thus infected is liable to be. attacked. These "facts together constitute another and very obvious reason why we should boil or sterilise our milk. THE! SYMPTOMS. I have said that .scarlet fever has a certain period known as that of incubation. This is characteristic of all infections diseases. It Irs the period between the time that we receive the germs into our bodies and that at which the active symptoms of the fever appear. In scarlet fever tills period, varies greatly. An infected child may develop the .actual* symptoms of Che fever, it is said, within twelve or twenty-four hours after infection. The period, on the other hand, may be delayed for several days. During this time the child is sick, suffers; from, headaches, is extremely, restless at night, and tho temperature rises, to 102 or 103 degrees. The mother, who is accustomed to the use cf tko thermo-motor for the purpose of ascertaining the state of health cf her children will find that extremely valuable, thero-

fore, where she suspects infection. In the next instance, as the disease develops we find sore throat complained of. The -tonsils swell, and the throat at large exhibits a high state of inflammation,. Particularly should] the tongue be looked at, because the littlei papillae or points on the tongue which exercise the sense of taste project as little reddened. points through the white far which coats it. This appearance is highly characteristic of scarlet fever, and nurses term it “strawberry tongue.” After these symptoms appear within two days the rash revel ops. The fever bias obtained its name from the appearance of the rash. It. first appears in. the upper part of the chest, and on the neck, and also on part cf the face. In its character the rash is of a. fine nature', and consists of very small specks, ted in colour. The skin itself is. also reddened. The rash in a few hours passes to the body and limbs. Lasting from three to four days, it then fades amid by the seventh or eight, day of the fever it will have disappeared. THE TREATMENT.

In an ordinary case when the rash disappears the symptoms of the fever tend to decrease in severity, but later on comes a symptom of scarlet fever showing how materially the skin is affected with this disease—namely, that what is called the peeling or obsquaniation of the skin surface, it is important to note that the skin peeling substitutes the most dangerous period of the fever in so far as liability to affe.•: < t!ie:s is concerned, seeing that til’s fever is generally regarded as oei ig ’ lnlncl'.ous front the first, the secretions of the throat and mouth being capable probably of conveying it to lisa‘.toy persons. In the treatment of the disease iae;efore, it is very proper, t.y wa\ of preventing the escape of this sis m sriuf, and by way of thus limiting the chance of infection, to anoint- the body t.f the patient every 24 hours with a disinfectant ointment. Carbolic ointaient is sometimes used for this purpose, a.s also' is iza! ointment, whilst some p!iys:c.ai s content themselves with apply mg simply plain olive oil. Note that after scarlet fever certain complications are liable to occur. The mother inrso be ex-, tremely careful to keep the < hild free from all risk of coid and chi I* ot Lei wise kidney troubles are most apt t>» supervene. Also, as in the case 1 of measles, affections of the ear are. liable to happen, and whenever a child shows these ear symptoms an oa- specialist should at once be consumed. Jf tho ear trouble is allowed to pass to the .vujje of suppuration, and the formation of matter be not checked, tun drum of the ear may be destroyed, and permanent deafness be the lot of the eh id Wh o reference to the treatni; it of a case of this fever, as far as regards the heme management, it is fairy simple. J lie bowels should first of all be cleared by giving a dose of castor mi. 'I he food will largely consist of milk, with milk puddings and any otair diet cf befit kind. If the throat is extremely sore the patient may drink watc w irrli has in a pint of it sixty grams.-. <f rbhra'e of potash dissolved therein. In The case of a bad sore b'i:*o* t hot poultices may be applied thereto, u !:i!st the doctor may in a severe case crde v stimulants by way of oou'n te r a cting any t endency to collapse. Itcmember that scarlet- fever in a l ous-uiold which ma ■ begin with a mild case may develop into fever of a much more severe C pe. Scarlet fever is, therefore, a disease which should be rigidly watched by way of noting any tendency towards the development of the malignant spores of the disease.