HEALTH COLUMN.

Otago Witness, Issue 1851, 30 March 1904, Page 68

HEALTH COLUMN.

SCARLET FEVER.

(By Db Andrew Wilrox, F.E.S.E., m .the

London Weekly Telegraph.)

That scarlet fever is caused by the spread and multiplication of a particular kind of microbe or germ in our bodies goes without saying. In all its ways and symptoms this ailmenc exhibits the characteristics of a germ-produced affection. In the first place, it is highly infcctiovis. 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 geims produced in the patient's body are capable, when conveyed to healthy persons, of infecting them. On all of these grounds we may therefore rest well assured that ecarlet fever iis a germ-produced ailment.

— Mod© of Infection —

I make these remarks for the purpose cf impressing these primary facts on my readers, and also for the reason that the 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 exact nature of this microbe. "When cases of scarlet fever are examined by 'way of detecting the germ to which the ailment ie due, it is fo^und that a large number of miciobes are included in what we may call the scientific man's~bag. His great difficulty in this case is practically that of separating otit from the mass of germs thus acquired the exact microbe to which the fever is due. The process of discovering the special germ is a long and tediotis one, involving an immense amount of work in the laboratory, the cultivation of many epecies of germs, and finally determining, always a difficult point, of the particular microbe which is responsible for the fever. Theie is no doubt that in the vast majority of cases scarlet fever is conveyed to xis by means of milk which has been infected by the germ. What 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 cow may suffer occasionally from an ailment which appears to represent scarlet fever in that animal. In such a caee (represented by a remarkable epidemic in London in 1885) the disease of the coiv, undoubtedly affecting her milk, is thus conveyed to human beings. In the vast majority of cases, however, milk is contaminated not by the cow, but by human beings suffering from the disease. Hence we see the extreme importance of the regular inspection not merely Sf dairy farms, but of shops where milk is sold. One extremely interesting and slllmportant point involved in this consideration is that which teaches us that occasionally we meet with extremely mild cases of the disease. These are case* in, which, the

patient is very slightly affected, and may uofc require to take to bed at all. Nevertheless, tb&re is found on examination a suspicious soro threat, whilst when the stage of faotterncss arrives the peeling off of the skin, so marked in ordinary cases; may be represented by a mere slight scurf typically found between the fingere. Mild as these casca are, they are nevertheless capable of conveying the disease to other persons, and if we suppose- the caso of any person who handles milk being thus infected, and the occurrence- of the disease- being practically un-uspected, ib is clear how an epidemic of cases may thus be eet; xip. Each household receiving- milk thus infected is liable to bo 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 infectious di&eascs. It is the period between the time that we receive the germs into our bodies and that at which the. active symptdrn? of the fever appear. In scarlet fever this period varies greatly. An infected child may develop the actual symptoms of the fev-er, it is said 1 , within 12, or 24, hours aftei- infection. The period, on the other hand, may he delayed for several days. During- this time the child is sick, suffers from headache-, is extremely restless r.t night, and the temperature rises to 102deg or lOScleg. The mother who is accustomed to the usa of the thermometer for the purpose of ascertaining the state of health cf her children, will find that instrument e-xtremeiy valuable, therefore, where she euspeete infection. In the next instance, as <he disease develops, we find sore throat complained of. The tonsils swell, and the throat at largo exhibits a high state of inflammation. Particularly should the tongue be looked at, because the little papillas or poi its on the tongue which exercise the censs of taste project a-s little- reddened points through the white fur which coats it. This appearance is highly chDraeteristio of scarlet fever, and nurses term it "strawberry tongue."' After these symptoms appear, within two days the rash develops. The fe-ver has obtained its name from the appearance of the rash. It first appears in the upper part of the chest, and on the ne-c'k, and also c?i part of the face. 11l its character, the rash i=; of a fino nature, and consists of very small ppecks, red in colour. The skin itself is ako reddened. The rash in a few hours passes to the body and limbs. Lasting from three "to four days, it then fades, and by the seventh or eighth day of the fever it will have disappeared. —The Treatment.— In an ordinary case, when the rash disappears, the symptoms of the fever tend t" decrease in severity ; but later on comes a fi}'mptom of scarlet fever showing how materially tha skin is affected with this disease — namely, that what is caled peeing or obsquamation of the skin surface, diseaoe — namely, that what is called peeling eom-titutes the most dangerous period of the fever, in so far as liability to affect others is concerned, seeing that this fever is generally regarded as being infectious from the first, the eeoretions of the throat and mouth being capable probably of conveying it to healthy persons. In the treatment of the disease,^ therefore, it is very proper, by way of preventing the escape of this skin scurf, and by way of thus limiting the chance of infection, to anoint the body of the .patient every 24- hours with a disinfectant ointment. Carbolic ointment is sometimes used for this purpose, a& also is izal ointment, whilst eomo physicians content themselves with applying simply olive oil. Note that after scarlet fever certain complications are liable to occur. The mother must be extremely careful to keep tho child free from all risk of cold and chill, otherwise kidney troubles are most apt to supervene. Also, as in the case of measles, affections' of the ear are liable to happen, and whenever a child shows these ear symptoms, an ear specialist should at once be consulted. If the ear trouble is allowed to pass to th& stage of suppuration, and the formation of matter be no-t checked, the drum of the ear may be destroyed, and permanent deafness be the lot of the child. "With reference to the treatment of a case of trhis fever, as far as regards the home management, it is fairly simple. The bowels ehoulcl first of all be cleared by giving a dose of castor oil. Th-e food will largely consist of milk, with milk puddings and any other diet of a light kind. If the throat is exfciemely sore, the patient may drink water which has dissolved in a pint of it 60 grains of chlorate of potash. In the case of a bad sore throat, hot poultices may be applied thereto, whilst the doctor may, in a severe case, order stimulants by way of counteracting any tendency' to collapse. Remember that scarlet fever in a household which may begin with a mild case may develop into fevei of a much more severe type. Scarlet fever is, therefore, a disease which should l be rigidly watched by way of noting any tendency towards the development of the malignant species of the disease.