Rural Hygiene

by Henry N. Ogden

In themselves, these diseases may not be severe, children often having mild attacks of scarlet fever, called scarletina, and apparently suffering only from a cold, but exposure, by which a cold is developed either during or after the disease, may lead to serious troubles. Inflammation of the kidneys often occurs, which may develop into chronic Bright's disease and ultimately cause death. Inflammation of the ear is another incident of scarlet fever, in which abscesses are formed, resulting not infrequently in permanent deafness.

The consequences of measles are not so serious usually, and a more common after effect is trouble with the lungs or bronchial tubes. Pneumonia, croup, and bronchitis very often follow measles, due, as already indicated, to exposure before the body has regained its normal condition. In both scarlet fever and measles the eyes are apt to be affected, and it is very important in both diseases to keep the patient in a darkened room and to forbid use of the eyes in reading or other close work. On account of the complications following scarlet fever and measles, as well as for their greater death-rate, these diseases are more serious than the other two included in this discussion,—whooping cough and chicken pox.

Preliminary symptoms.

The beginning of each of these four diseases is much the same, and the symptoms are likely to be mistaken for those of an ordinary cold. In all of them, the first indication of illness is redness and itching on the inside of the nose and throat with snuffling and discharging from both eyes and nose. Sometimes the throat is affected, and the patient complains of sore throat. Then the cheeks become flushed, headache may follow, and fever begins, so that the patient is in a sort of stupor, unwilling to do anything and glad to lie in bed. In severe cases vomiting may accompany or precede the outbreak of fever.

At the outset, the probable reason for the similarity of these four diseases as well as their likeness to a common cold is that the germs responsible for all of them enter the body through the nose and throat and begin their attack upon the membranes there. The action of the germ is followed by the formation of poisons or toxins which are distributed by the blood through the body, causing the fever and what are known as "general symptoms." At the beginning it is not possible to determine to which particular germ the distress of the patient is due, and probably the continued prevalence of these diseases is chiefly owing to the fact that in the early stages and in mild cases throughout, the sufferer is allowed to be at large with every opportunity for spreading the disease.

Contagiousness.

If, whenever a child has a cold accompanied by a fever, the mother would promptly put him in bed in a room by himself, keeping the other children of the family away from the sick room and the invalid under restraint until all possibility of transmitting the disease is over, the number of cases would be greatly diminished. Unfortunately, there seems to be a general impression that such precautions are useless, and that sooner or later every child must have these children's diseases. This is a mistaken notion, and the table already referred to is sufficient evidence to prove the error of this way of thinking.

All these diseases are affections of the whole body, caused by poisons generated by germs, for which so far scientists have found no antidote. The reason is plain. The germ itself is not known, and no animal has been discovered on which scientists can experiment. If we could only produce measles in a rabbit, for instance, we could very soon detect the germ and would no doubt be able to procure an antidote to the measles poison. But this has not been done, and therefore in measles and in the other diseases mentioned we can only hope that the sick person will be able to generate in his own body sufficient antidote to secure his own recovery. Physicians therefore are almost helpless in treating these diseases. They keep the patient in bed in order that all his strength may be kept for fighting the disease. They insist on ventilation in abundance, so that oxygen may be applied to the lungs in large quantities in order to neutralize the poison. They advise sponge baths in cold water and alcohol to allay the fever, and they prescribe nourishing, easily digested food, such as milk, eggs, fruit, and plenty of water to drink. In the hope of diminishing the chances of infection, particularly in measles and scarlet fever, they recommend antiseptic sprays for the nose and throat and antiseptic ointments, such as carbolized vaseline for the skin when peeling or desquamation is going on.

Quarantine for scarlet fever.

Scarlet fever, while the most violent, is also the shortest lived, in the majority of cases not more than three or four days, although the full period of recovery is much longer. The peculiarity of this disease lies in the abundant peeling which takes place usually from the entire body and particularly from the hands and feet; in fact, in a number of cases where the disease is light, the peeling from the hands and feet is the only positive proof that the malady has been scarlet fever. During this process of peeling contagion seems most active; therefore, although recovery seems entire so far as the fever is concerned, the patient should remain strictly isolated during this time. It is a slow process, lasting from two to five weeks, and is very tiresome for the child who feels perfectly well; yet, in the interests of other children, the child must be kept strictly at home until at least a week after the last sign has disappeared. It is also for the child's own sake very desirable to observe this quarantine, since it is during this period of recovery that most of the complications of scarlet fever occur, and if the patient is kept under observation, either in his sick room or on some porch where atmospheric exposure is not too great and where the child is certain to eat nothing harmful, the chances for avoiding lung troubles and digestive disturbances are minimized.