Year: 1879

-~


dence.


In view of the large number of cases
of scarlet fever prevailing in New York,
the World sent reporter to one of the
best-known physicians in the city, DR..
Fordyce Barker, from whom the fol
lowing facts and opinions concerning
the disease were gathered


The reporter asked if scarlet fever
could be called disease of modern
times and was unknown to the ancients.


"It was first described by Sydenham
in the seventeenth century," answered
Professor Barker, "as distinct dis
ease."


"Are there great differences in the
severity of such epidemics 2"


every great differences; some epi-
denies being mild and some attended
with severe and dangerous cases. But
there are always mild cases during the
most severe epidemics."


"What are the causes of scarlet
fever ?"


"The specific cause is infection by
specific poison which is communicated
by direct contact either with the exhala-
tions from the lungs of patients, with
their skin, or by means of clothing or
various substances with which the
patients have come in contact. Scarlet
fever is said to have been communicated
by milk, or even by letter. Taylor,
an eminent English writer, reports the
beginning of one epidemic as being in
the family of milkman who delivered
milk to twelve families. OF these fami-
lies six had scarlet fever as consequence.
A certain individual predisposition must
exist, as it is frequently found that one
child in family may take the disease,
while others of the children who have
frequently been exposed in the same de-
gree do not get it.


care individuals who have had the
disease in mild form more liable to
second attack ?"


"I should say not. On the contrary,
those who have constitutional predilec-
tion to the disease are more liable to
second attack. Ordinarily one at
tack secures immunity from a second,
but there are many exceptions to this.
1t is very rare that patients die from a
second attack. In fact not more than
three or four cases of this Kind have
been reported in medical literature"


"How long does the poison retain
its activity in clothing, furniture, rooms,
etc. ?"


"This is very uncertain. There is
conclusive evidence that it has been re-
tanned in clothing sometimes for months.
For example, lady assisted in nursing
the children of sister in the country
in the month of August. In the follow
ing February one of her own children
was attacked with the disease and sub
sequently two others. 1t was then
found that this lazy had put on dress
ing gown she had worn at her sisters
the previous August, and had taken in
her lap the first of her own children
which was attacked at the time she put
on this gown again for the first time.
In another case, nurse who had been
in attendance on scarlet-fever patients
four months before seems to have COM
municated the disease to lady whom
she was attending who had young in
FAINT. Another case was that of a lady
who had novel into house where there
had been scarlet fever some months
before Three of her children were
attacked with the disease who had not
been exposed to infection from any
other source, and no other cases were
prevailing at the time that could be
heard of by the lady's physician.


Chow soon is the disease developed
after infection?"


Trousseau reports case in which the
disease was manifested in twenty four
hours after exposure, and similar cases
are reported but usually the period of
development is from three to ten or
twelve days after exposure. This is prob
ably due to the difference in the sus-
ceptibility of the patients.


sat what period of the disease, and
how long is it infectious2


"It is infectious throughout its whole
course. It is believed to be most in
tensely so during the period of desqua-
nation, or when the skin is peeling off;
but so long as there is any evidence OF
disturbance of the system from the
localization of the poison in any organ,
it is not safe to assume that the disease
is not communicable.


"What is the comparative suscepti-
bility to and danger from the disease at
different ages?"


& The most susceptible period OF life is
from one to fifteen years. Murchison, a
very high authority, states from the
statistics of nearly 10000 cases that
about sixty-four per cent. of deaths
from scarlet fever are under five years,
and nearly ninety per cent. under ten
years; ninety-fve and half per cent.
under fifteen years, and only one and
three-fourths per cent. over twenty-five
years. Scarlet fever is very rare in
young infants. Only one-ninetieth of
all the deaths are under one year, and
one-ffteenth between one and two
years"


"How can scarlet fever be prevented
and alleviated ?"


"To prevent scarlet fever, complete
isolation of the patients is absolutely
essential, as we'll as the prevention of all
contact with those in attendance on the
diseased persons. 1t is essential also
that the house should be thoroughly
ventilated, SO that the poison which
may escape may be as diluted as posi-
BILE. All clothing should be thoroughly
disinfected, and even the soiled linen Of
the sick should not be mingled with
that Of the other members of the house
hold. The relief of the patients pertains
to the medical treatment. After the
disease is recovered from, the sick-room
should be thoroughly disinfected, al
we'll as the bedding, the furniture, the
carpets, and even the walls. 1t is founG
that dry heat to the point of 212 degrees
kept up for some hours, effectually de
stroys the poison; and this, perhaps, il
as good a method as any Of disinfectine
the haddinp of those who cannot AFFORD