Advice to a Mother on the Management of Her Children

by Pye Henry Chavasse

The essential remedies, then, in scarlet fever, are, for the first few days—(1) plenty of fresh air and ventilation, (2) plenty of cold water to drink, (3) barm poultices to the throat, and (4) the Acidulated Infusion of Roses Mixture as a medicine.

Now, then, comes very important advice. After the first few days, probably five or six, sometimes as early as the fourth day—watch carefully and warily, and note the time, the skin will suddenly become cool, the child will say that he feels chilly; then is the time you must now change your tactics—instantly close the windows and put extra clothing, a blanket or two, on his bed. A flannel nightgown should, until the dead skin have peeled off, be now worn next to the skin, when the flannel nightgown should be discontinued. The patient ought ever after to wear, in the day time, a flannel waistcoat. [Footnote: On the importance—the vital importance—of the wearing of flannel next to the skin, see "Flannel Waistcoats.">[ His drinks must now be given with the chill off; he ought to have a warm cup of tea, and gradually his diet should, as I have previously advised, be improved.

There is one important caution I wish to impress upon you,—do not give opening medicine during the time the eruption is out. In all probability the bowels will be opened: if so, all well and good; but do not, on any account, for the first ten days, use artificial means to open them. It is my firm conviction that the administration of purgatives in scarlet fever is a fruitful source of dropsy, of disease, and death. When we take into consideration the sympathy there is between the skin and the mucous membrane, I think that we should pause before giving irritating medicines, such as purgatives. The irritation of aperients on the mucous membrane may cause the poison of the skin disease (for scarlet fever is a blood-poison) to be driven internally to the kidneys, to the throat, to the pericardium (bag of the heart), or to the brain. You may say, Do you not purge if the bowels be not open for a week? I say emphatically, No!

I consider my great success in the treatment of scarlet fever to be partly owing to my avoidance of aperients during the first ten days of the child's illness.

If the bowels, after the ten days, be not properly opened, a dose or two of syrup of senna should be given: that is to say, one or two tea-spoonfuls should be administered early in the morning, and should, if the first dose does not operate, be repeated in four hours.

In a subsequent Conversation, I shall strongly urge you not to allow your child, when convalescent, to leave the house under at least a month from the commencement of the illness; I, therefore, beg to refer you to that Conversation, and hope that you will give it your best and earnest consideration! During the last twenty years I have never had dropsy from scarlet fever, and I attribute it entirely to the plan I have just recommended, and in not allowing my patients to leave the house under the month—until, in fact, the skin that had peeled off has been renewed.

Let me now sum up the plan I adopt, and which I beg leave to designate as—Pye Chavasse's Fresh Air Treatment of Scarlet Fever:—

1. Thorough ventilation, a cool room, and scant clothes on the bed, for the first five or six days.

2. A change of temperature of the skin to be carefully regarded. As soon as the skin is cool, closing the windows, and putting additional clothing on the bed.

3. The Acidulated Infusion of Hoses with Syrup is the medicine for scarlet fever.