Exposure to cold and lowered vitality from overwork, alcoholism, or some previous disease render persons liable to infection.
Symptoms.—These consist in a decided chill, pain in the side, fever rising rapidly to 104°-105° F., and lasting for five, seven, nine, or eleven days, and then rapidly falling; cough; tenacious bloody expectoration, shortness of breath, delirium and stupor, and physical signs indicating a solid condition of the affected lung.
In fatal cases death usually results from exhaustion, the result of the systemic poisoning, but occasionally it is due to a failure of the heart to propel the blood through the solid lung, to suffocation, or a complication, such as inflammation of the covering of the heart (pericarditis) or lining of the heart (endocarditis).
Management.—The room should be well ventilated, but free from drafts. The temperature should be maintained between 65° and 70° F. Cool water should be given freely. The points mentioned in connection with temperature, respiration, and pulse in dealing with typhoid fever are applicable here. Note the frequency of cough, the amount and character of expectoration, and whether the latter is raised readily or with difficulty. Note the occurrence of pain and its location; also amount of sleep, amount of nourishment, amount of urine, number of stools, etc., and the effect of sponging, of medicines, and of local applications. Clean the mouth and teeth at intervals, being extremely careful, however, in all manipulations not to tire or exhaust the patient.
SCARLET FEVER.
Scarlet fever is an acute, highly contagious disease characterized by a sudden onset with chill, vomiting, or convulsions; a high fever of from a week to ten days’ duration; a very rapid pulse; severe sore throat; a bright red rash, appearing on the second day, lasting about a week, and followed by desquamation and a marked tendency to nephritis.
The most serious complications are nephritis, suppurative inflammation of the middle ear (otitis media), inflammation of the endocardium or pericardium, and pneumonia.
Scarlet fever, while contagious at all periods, is probably most so during the period of desquamation. The organism may cling to furniture, clothing, etc., and reproduce the disease after very long periods. The contagion may be carried by persons coming in contact with the sick, or the disease may be transmitted through the air of the sick-room or through clothing, utensils, etc., which have been used by the sick.
Prevention of contagion consists in isolating the patient; in disinfecting everything that has been in contact with him; in anointing the patient’s body with an antiseptic oil until desquamation is complete; and in thoroughly disinfecting the room after the patient’s removal.
Management.—Have the patient, if possible, in a large, airy room, preferably at the top of the house. Keep the temperature uniform and the room well ventilated. Wear a loose wrapper and cap, and leave these inside the room when obliged to leave it.