Advice to a wife and mother in two parts

by Pye Henry Chavasse

222. What means do you advise to purify a house from the contagion of Scarlet Fever?

Let every room be lime-washed and then be white washed;[^[236]] if the contagion has been virulent, let every bedroom be freshly papered (the walls having been previously stripped of the old paper and then lime-washed); let the bed, the bolsters, the pillows, and the mattresses be cleansed and purified; let the blankets and coverlids be thoroughly washed, and then let them be exposed to the open air—if taken into a field so much the better; let the rooms be well scoured; let the windows, top and bottom, be thrown wide open; let the drains be carefully examined; let the pump-water be scrutinized, to see that it be not contaminated by fecal matter, either from the water-closet or from the privy; let privies be emptied of their contents—remember this is most important advice—then put into the empty places lime and powdered charcoal, for it is a well-ascertained fact that it is frequently impossible to rid a house of the infection of scarlet fever without adopting such a course. “In St. George’s, Southwark, the medical officer reports that scarlatina ‘has raged fatally, almost exclusively where privy or drain smells are to be perceived in the houses.’”[^[237]] Let the children who have not had, or who do not appear to be sickening for scarlet fever, be sent away from home—if to a farm-house so much the better. Indeed, leave no stone unturned, no means untried, to exterminate the disease from the house and from the neighborhood.

223. Will you describe the symptoms of Chicken-pox?

It is occasionally, but not always, ushered in with a slight shivering fit; the eruption shows itself in about twenty-four hours from the child first appearing poorly. It is a vesicular[^[238]] disease. The eruption comes out in the form of small pimples, and principally attacks the scalp, the neck, the back, the chest, and the shoulders, but rarely the face; while in small-pox the face is generally the part most affected. The next day these pimples fill with water, and thus become vesicles; on the third day they are at maturity. The vesicles are quite separate and distinct from each other. There is a slight redness around each of them. Fresh ones, while the others are dying away, make their appearance. Chicken-pox is usually attended with a slight itching of the skin; when the vesicles are scratched the fluid escapes, and leaves hard pearl-like substances, which, in a few days, disappear. Chicken-pox never leaves pit-marks behind. It is a child’s complaint; adults scarcely, if ever, have it.

224. Is there any danger in Chicken-pox; and what treatment do you advise?

It is not at all a dangerous, but, on the contrary, a trivial complaint. It lasts only a few days, and requires but little medicine. The patient ought, for three or four days, to keep the house, and should abstain from animal food. On the sixth day, but not until then, a dose or two of a mild aperient is all that will be required.

225. Is Chicken-pox infectious?

There is a diversity of opinion on this head, but one thing is certain—it cannot be communicated by inoculation.

226. What are the symptoms of Modified Small-pox?

The modified small-pox—that is to say, small-pox that has been robbed of its virulence by the patient having been either already vaccinated, or by his having had a previous attack of small-pox—is ushered in with severe symptoms, with symptoms almost as severe as though the patient had not been already somewhat protected either by vaccination or by the previous attack of small-pox—that is to say, he has a shivering fit, great depression of spirits and debility, malaise, sickness, headache, and occasionally delirium. After the above symptoms have lasted about three days, the eruption shows itself. The immense value of the previous vaccination, or the previous attack of small-pox, now comes into play. In a case of unprotected small-pox, the appearance of the eruption aggravates all the above symptoms, and the danger begins; while in the modified small-pox, the moment the eruption shows itself, the patient feels better, and, as a rule, rapidly recovers. The eruption of modified small-pox varies materially from the eruption of the unprotected small-pox. The former eruption assumes a varied character, and is composed, first of vesicles (containing water), and secondly of pustules (containing matter), each of which pustules has a depression in the center, and thirdly of several red pimples without either water or matter in them, and which sometimes assume a livid appearance. These “breakings-out” generally show themselves more upon the wrist, and sometimes up one or both of the nostrils. While in the latter disease—the unprotected small-pox—the “breaking-out” is composed entirely of pustules containing matter, and which pustules are more on the face than on any other part of the body. There is generally a peculiar smell in both diseases—an odor once smelt never to be forgotten.