Advice to a Mother on the Management of Her Children

by Pye Henry Chavasse

4. Purgatives to be religiously avoided for the first ten days at least, and even afterwards, unless there be absolute necessity.

5. Leeches, blisters, emetics, cold and tepid spongings, and painting the tonsils with caustic, inadmissible in scarlet fever.

6. A strict antiphlogistic (low) diet for the first few days, during which time cold water to be given ad libitum.

7. The patient not to leave the house in the summer under the month; in the winter, under six weeks.

What NOT to do.—Do not, then, apply either leeches or blisters to the throat; do not paint the tonsils with caustic; do not give aperients; do not, on any account, give either calomel or emetic tartar; do not, for the first few days of the illness, be afraid of cold air to the skin, and of cold water as a beverage; do not, emphatically let me say, do not let the child leave the house for at least a month from the commencement of the illness.

My firm conviction is, that purgatives, emetics, and blisters, by depressing the patient, sometimes cause ordinary scarlet fever to degenerate into malignant scarlet fever.

I am aware that some of our first authorities advocate a different plan to mine. They recommend purgatives, which I may say, in scarlet fever, are my dread and abhorrence. They advise cold and tepid spongings—a plan which I think dangerous, as it will probably drive the disease internally. Blisters, too, have been prescribed; these I consider weakening, injurious, and barbarous, and likely still more to inflame the already inflamed skin. They recommend leeches to the throat, which I am convinced, by depressing the patient, will lessen the chance of his battling against the disease, and will increase the ulceration of the tonsils. Again, the patient has not too much blood; the blood is only poisoned. I look upon scarlet fever as a specific poison of the blood, and one which will be eliminated from the system, not by bleeding, not by purgatives, not by emetics but by a constant supply of fresh and cool air, by the acid treatment, by cold water as a beverage, and for the first few days by a strict antiphlogistic (low) diet. Sydenham says that scarlet fever is oftentimes "fatal through the officiousness of the doctor." I conscientiously believe that a truer remark was never made; and that, under a different system to the usual one adopted, scarlet fever would not be so much dreaded. [Footnote: If any of my medical brethren should do me the honour to read these pages, let me entreat them to try my plan of treating scarlet fever, as my success has been great. I have given full and minute particulars, in order that they and mothers (if mothers cannot obtain medical advice) may give my plan a fair and impartial trial. My only stipulations are that they must begin with my treatment, and not mix any other with it, and carry out my plan to the very letter. I then, with God's blessing, provided the cases be neither malignant nor complicated with diphtheria, shall not fear the result. If any of my confreres have tried my plan of treatment of scarlet fever—and I have reason to know that many have—I should feel grateful to them if they would favour me with their opinion as to its efficacy. Address—"Pye Chavasse, 214 Hagley Road, Birmingham.">[

Dr Budd, of Bristol, recommends, in the British Medical Journal, that the body, including the scalp, of a scarlet fever patient, should, after about the fourth day, be anointed, every night and morning, with camphorated oil; this anointing to be continued until the patient is able to take a warm bath and use disinfectant soap: this application will not only be very agreeable to the patient's feelings, as there is usually great irritation and itching of the skin, but it will, likewise, be an important means of preventing the dead skin, which is highly infectious, and which comes off partly in flakes and partly floats about the air as dust, from infecting other persons. The plan is an excellent one, and cannot be too strongly recommended.

If the case be a combination of scarlet fever and of diphtheria, as it unfortunately now frequently is, let it be treated as a case of diphtheria.

224. I have heard of a case of Scarlet Fever, where the child, before the eruption showed itself, was suddenly struck prostrate, cold, and almost pulseless: what, in such a case, are the symptoms, and what immediate treatment do you advise?