Advice to a wife and mother in two parts

by Pye Henry Chavasse

Take down the curtains of the bed; remove the valances. If it be summer time, let the child be only covered with a sheet: if it be winter time, in addition to the sheet, he should have one blanket over him.

Now for the throat.—The best external application is a barm and oatmeal poultice. How ought it to be made, and how applied? Put half a teacupful of barm into a saucepan, put it on the fire to boil; as soon as it boils take it off the fire, and stir oatmeal into it, until it is of the consistence of a nice soft poultice; then place it on a rag, and apply it to the throat; carefully fasten it on with bandage, two or three turns of the bandage going round the throat, and two or three over the crown of the head, so as nicely to apply the poultice where it is wanted—that is to say, to cover the tonsils. Tack the bandage: do not pin it. Let the poultice be changed three times a day. The best medicine is the acidulated infusion of roses, sweetened with syrup.[^[233]] It is grateful and refreshing, it is pleasant to take, it abates fever and thirst, it cleans the throat and tongue of mucus, and is peculiarly efficacious in scarlet fever; as soon as the fever is abated it gives an appetite. My belief is that the sulphuric acid in the mixture is a specific in scarlet fever, as much as quinine is in ague, and sulphur in itch. I have reason to say so, for, in numerous cases, I have seen its immense value.

Now, with regard to food.—If the child be at the breast, keep him entirely to it. If he be weaned, and under two years old, give him milk and water, and cold water to drink. If he be older, give him toast and water, and plain water from the pump, as much as he chooses; let it be quite cold—the colder the better. Weak black tea, or thin gruel, may be given, but not caring, unless he be an infant at the breast, if he take nothing but cold water. If the child be two years old and upwards, roasted apples with sugar, and grapes will be very refreshing, and will tend to cleanse both the mouth and the throat. Avoid broths and stimulants of every kind.

When the appetite returns, you may consider the patient to be safe. The diet ought now to be gradually improved. Bread and butter, milk and water, and arrow-root made with equal parts of new milk and water, should for the first two or three days be given. Then a light batter or rice pudding may be added, and in a few days afterward, either a little chicken or a mutton-chop.

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 night-gown should, until the dead skin has peeled off, be now worn next to the skin, when the flannel night-gown should be discontinued. The patient ought ever after to wear, in the daytime, a flannel waistcoat.[^[234]] 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 recommended 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, are not properly opened, a dose or two of the following mixture should be given:

Take of—Simple Syrup, three drachms;