Outlook.—Chickenpox almost invariably results in a rapid and speedy recovery without complications or sequels. The young patients often feel well throughout the attack, which lasts from eight to twelve days.
Treatment.—Children should be kept in bed during the eruptive stage until the blisters have dried. To prevent scratching, the calamine lotion may be used (Vol. II, p. 145), or carbolized vaseline, or bathing with a solution of baking soda, one teaspoonful to the pint of tepid water. The diet should be that recommended for German measles. Patients should be kept in the house and isolated until all signs of the eruption are passed, and then receive a good bath and fresh clothing before mingling with others. The sick room should be thoroughly cleaned and aired; thorough chemical disinfection is not essential.
The services of a physician are always desirable in order that it may be positively determined that the disease is not a mild form of smallpox.
CHAPTER II
Infectious Diseases
Typhoid Fever—How it is Contracted—Complications and Sequels—Rest, Diet, and Bathing the Requisites—Mumps—Whooping Cough—Erysipelas.
TYPHOID FEVER (ENTERIC FEVER).—Through ignorance which prevailed before the discovery of the germ of typhoid fever and exact methods for determining the presence of the same, the term was loosely applied and is to this day. Thus mild forms of typhoid are called gastric fever, slow fever, malarial fever, nervous fever, etc., all true typhoid in most cases; while typhoid fever, common to certain localities and differing in some respects from the typical form, is often named after the locality in which it occurs, as the "mountain fever" common to the elevated regions of the western United States. This want of information is apt to prevail in regions remote from medical centers, and leads to neglect of the necessary strict measures for the protection of neighboring communities, for the excretion of one typhoid patient has led to thousands of cases and hundreds of deaths.
Typhoid fever is a communicable disease caused by a germ which attacks the intestines chiefly, but also invades the blood, and at times all the other parts of the body, and is characterized by continued fever, an eruption, tenderness and distention of the bowels, and generally diarrhea. It is common to all parts of the earth in the temperate zones, and occurs more frequently from July to December in the north temperate zone, from February to July in the south temperate zone. It is most prevalent in the late summer and autumn months and after a hot, dry summer. Individuals between the ages of fifteen and thirty are more prone to typhoid fever, but no age is exempt. The sexes are almost equally liable to the disease, although it is said that for every four female cases there are five male cases. The robust succumb as readily as the weak.
Cause and Modes of Communication.—While the typhoid germ is always the immediate cause, yet it is brought in contact with the body in various ways. Contamination of water supply through bad drainage is the principal source of epidemics of typhoid. Before carefully protected public water supplies were in vogue in Massachusetts, there were ninety-two deaths from typhoid fever in 100,000 inhabitants, while thirty-five years after town water supplies became the rule, there were only nineteen deaths for the same population. Whenever typhoid is prevalent, the water used for drinking and all other household purposes should be boiled, and uncooked food should be avoided. Flies are carriers of typhoid germs by lighting on the nose, the mouth, and the discharges of typhoid patients, and then conveying the germs to food, green vegetables, and milk. Cooking the food, preventing contact of flies with the patients, and keeping flies out of human habitations becomes imperative. Milk is a source of contagion through contaminated water used to wash cans, or to adulterate it, or through handling of it by patients or those who have come in contact with patients. Oysters growing in the mouths of rivers and near the outlets of drains and sewers are carriers of typhoid germs, and, if eaten raw, sometimes communicate typhoid fever. Dust is an occasional medium of communication of the germ. It is probable, however, that the germ always enters the body by being swallowed with food or drink, and does not enter through the lungs. There is little doubt on this point. Ice may harbor the germ for many months, for freezing does not kill it, and epidemics have been traced to this source. Clothing, wood, utensils, door handles, etc., which have been contaminated by contact with discharges from patients, may also prove mediums of communication of the typhoid germ to healthy individuals. Typhoid germs escape from patients sick with the disease chiefly in the bowel discharges and urine, sometimes in the sweat, saliva, and vomited matter.