The news & observer. [volume] (Raleigh, N.C.) 1894-current, 1900-01-28

perlntendentS OF Heath ana munlclpaA
health officers viii be very careful In
this matter of disinfection. "a lick and
a promise" will not answer, but the
work must be thoroughly done to be eff
factive, or seed-beds for another crop
next winter will be left For all out
breaks of this origin, the health officer
is responsible. for the law definitely and
positively makes it his duty TO see that
both quarantine and disinfection are
properly carried out. He should never
forget the fearful consequences that may
follow a neglect in any particular Of this
most important duty.
NEGLECT OF VACCINATION.
The neglect of vaccination is attribu-
table To several causes. ln the first
place. TO an unreasonable prejudice
against il on the part OK many people,
chiefly Of the more ignorant classes.
Owing to the remarkable mildness OF
the disease az it has so far appeared,
the death rate being less than two per
cent. the corrective effect of fear can
Of be brought to bear with much force
uuon this prejudice. So that this atti-
tude on the part of the people can be
understood, and in the case of the la
boring man who, with his family, is de-
pandent upon manual toll, perhaps, ex-
cused. But there is another influence
which re-enforces this prejudice and
nightly supports the obstructionists, and
that is what we call. rather inelegantly.
perhaps. the kicking doctor" We had
occasion TO refer to him last season. but
we had hoped that with increase OF
knowledge he would disappear, but it
seems that he is still with us. Generally
the physician who has talked the loudest
and longest in dispute OF the diagnosis
Of small poy has uniformly and persist
emily refused all invitations to see the
case. and for him, of course. there can
be no excuse whatever. But when the
disease first appeared there was I'M
doubtedly often reasonable ground for
doubt on the part OF even intelligent
and learned physicians.
QUEER FORMS.
The disease as il has appeared in this
country during the past two years in ad.
dition to its extraordinary mildness in
most cases, has assumed irregular and
unusual forms. different in some respects
from the description TO be found in the
text -books--the only sources Of informa-
ton, fortunately, for many years avail
able 10 an immense majority of our
medical practitioners. Hence, the CHER
reason for the mistakes in diagnosis. In
nearly every instance, however, the ex.
ceptions having been very rare, experts
have declared the disease 10 be gen
uine small pox. Now, these facts have
been before the medical public for at !,
least a year, and one would think that
they would be given due weight in COM
ing TO conclusion, but to our mind
the strangest feature of the position of
those denying the diagnosis of small
pox has been almost their invariable con
tention that the disease was chicken pox,
even when occurring in adults. We are
sure we are not expressing it too
strongly when we say that every physi-
clan that can fairly claim to be well-in-
formed knows that chicken pox is so rare
in adults that it is practically unworthy
of consideration i'll making diagnosis
OF an eruptiye disease in person past
the period of childhood. We will wager
that not one per cent of the physicians
of North Carolina ever saw single case
OF chicken poX in a grown person in the
ten years preceding 1898, notwithstand-
ing it's frequent prevalence among the
children of their clientele. Then, why
SO many cases Of chicken pox now, when
it is known of all men that genuine small
pox, although frequently atypical in
form, is widely prevalent.
GIVE 1T A BIG MAMIE.
We hope that hereafter any physician
who feels it incumbent on him TO up.
hold the proverb, doctors differ" when
the case under consideration is an adult,
and especially if the history OF recent
successful vaccination is not clear, will
fall back on something else than chick
en- pox--say ''impetigo contagiosa"-it
sounds bigger-or Cuban itch" or ele-
phant itch" or Georgia bumps" or
"any other old thing" But TESTING aside,
this is very serious matter, as we
know from experience. This refusal to
accept the diagnosis OF small pox, which.
with very rare exceptions, has always
proved to be correct, by few physicians
not many we are glad to Say-haS
done much harm in our State. II has
furnished 4 raliying cry for those OPP
posed TO vaccination, it has undermined
public opinion, and it has supplied an ex-
cuse for inaction to weakened Off
Gals. AS every one knows, promptness
and thoroughnesS of action upon the ap-
pearance of case of small pox in a
community, in isolating the case and all
who have been exposed, and in yaccinat-
ing all the people, are absolutely neces-
sary to its complete control. The ''ick-
ers'' impede and delay this action, and
in so far interfere with the welfare OF
the people.
We admit, of course, the right of every
man to his own opinion, but we deny tho
right to an unnecessary public express
sion Of that opinion when it is calculated
TO endanger the lives and prosperity OF
his neighbOrs.
DUTY OF DOCTORS.
In the face of the conditions that now
confront us, it seems TO us, with all duo
Difference. that the proper attitude OF
the patriotic physician towards smallpox
is this: If he has not seen the case he
case, he cannot. of course, give an opin-
ion as to the diagnosis, but if asked d.
rectly he should say--as the present
state of affairs would fully justify-that
he does not know. not having seen Il.
but that in view of the wide dissemina-
ton of the disease throughout the State
and country, it is most likely small pox.
and advise the questioner to be yacci-
mated with all under his control ut once.