The Birmingham age-herald., 1914-07-12


 Types of the Disease
 l. The mild abortive type, in which there are few symptoms of importance possibly slight sore throat or a very slight eruption.
 7. The malignant type in which there are all the characteristics of an over- whelmins intoxication, patients dying in from "A to 4S hours
 .. The hemorrhagic type in which there Is bleeding in the skin, organs, nose bleed, etc, and nearly always fatal.
 4. The throat type, in which there is intense inflammation in the throat, with formation of membranes, enlargement of glands and often abscess in the neck.
 Complications
 There are few diseases attended by as many complications as scarlet fever. Large abscess in the throat or neck inflammation of the middle ear, of the cells in the bone behind the ear. menin- gitis, and clots in the veins of the brain, inflammation of the lining and covering membranes of the heart. broncho pneumonia, pleurisy, inf1amma- ton of the joints, and nephritis or in- fiammation of the kidneys, which last is quite common, and often fatal. With the exception of the malignant type. deaths In scarlet fever are due to com PiiSotiohS, anu AHeSe are no doubt causced by the streptoeoccus germ above alluded to. Some or these cases are veritable ''pyemias," that is pus germs in the blood which find lodgement as above outlined and set up local infiam- matory action and forming pus. Some times, however, they do not form pus.
 Prevention of Scarlet Fever
 In the absence of definite knowledge as to the specific garm it's life history and habits, we are somewhat at a dis advantage in the prevention of the dis ease. But with the definite knowledge that the virus Is contained in the secretions of the nose, throat and respiratory tract" and that it enters through the mouth and respiratory pas sages," the problem is to take care of the infected secretions and to avoid as far as possible their entrance into well persons. The first thing Is complete isolation or quarantine of the patient. the second, the destruction of nose. throat and respiratory secretions" or their disinfection. and the destruction by burning or disinfection of all things that come in contact with the patient. Nothing should be removed from the room until disinfected All laundry should be immersed in carbolic acid one to 20 solution for one or two hours before being sent to the laundry, and the room and furniture thoroughly fum- igted after the complete desquamation of the patient. A hospital for contagious diseases is the proper place for the isolation and treatment of scarlet fever.
 Specific Prevention
 This consists in the injection of a bouillon culture of the streptocaccus isloted from person with scarlet fever. These are killed by exposing to a tenn perature of 60 degrees centigrade. Three doses are given in periods of sey en to ten days. (Gabritschensky's 8 method). It is claimed that after three injections complete immunity is es- saed after five to seven days for one and one-half years. These are cer- tam contra indications, and should be employed only by the advice of a phys ician. The prevention of complications are problems of treatment and, there fore, not matter for discussion in this paper. f
 In the next bulletin measles will be discussed.
 R. M. CUNNINGHAM, M. D.,
 City Health Officer.