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Medical CategoriesAccidents, Emergencies And Poisons
Diseases Of The Blood And Ductless Galnds
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Category: Infectious Diseases
By the rapid onset, absence of cold symptoms of the nose,
eyes, and bronchial tubes, blotchy eruptions that occur in measles. There
is no strawberry tongue in measles and no coughing at beginning.
Recovery. The prognosis is favorable in uncomplicated cases. It also
depends upon the character of the epidemic type of the disease. In England
it varies from thirteen to fourteen per cent. In this country it is
sometimes as low as two to four per cent. The kidney trouble is always
feared for it may result in uremia and death, or the acute may be followed
by chronic nephritis or Bright's disease, which will ultimately prove
Sanitary Care of Room and Patient. If you are exposed to this disease
what can you do? If a child, it must be put in a room by itself. If
several children have been exposed they should be put in separate rooms.
These rooms should have no carpet, curtains, rugs, etc., or any
unnecessary furniture, for everything must be disinfected afterward, and
sometimes destroyed. The clothes worn just before the sickness should be
sterilized in steam or boiled and then aired in the sun. Anyone suffering
from sore throat who has been about the patient should not be allowed to
be near the healthy. All the children must be kept from school. It is well
for them to spray their throats with a simple cleansing solution morning
and night, with a full teaspoonful of boric acid to a glass full of warm
water; or you can use common salt, but not strong enough to irritate the
throat, about one teaspoonful to a glass of water. If you have listerine
or glyco-thymoline or any such disinfectant use them, one teaspoonful to
sixteen spoonfuls of water. Hot water itself is a very good gargle, very
healing and cleansing. Anyone who enters the sick room and comes out again
should wear a sheet all over him. On coming out, he or she should leave
this sheet outside the window of another room. If the person has a beard
he should wash his face with a 1 to 2000 solution of corrosive sublimate,
and the hands also, before leaving the sick room. The one who waits upon
the sick one should remain there, but everyone can not do so. They must
stay away from the healthy if possible.
City and State Supervision. If you live in the city your physician should
notify the health board who will probably send someone to instruct you
regarding cautions and some cities have private rules, laws, etc., for
them to follow while under quarantine. A copy is usually furnished also to
your close neighbors. Also some of the state departments of health have
made up pamphlets which are circulated free on request dealing with the
sanitary science of infectious and contagious diseases. Some colleges use
these same pamphlets in their study of sanitary science. Much valuable
information is contained in them. Comparatively few people learn of these
pamphlets. For the benefit of those who have not read or seen them we
quote from their scarlet fever subjects as follows:
HOW TO AVOID AND PREVENT SCARLET FEVER.
Do not let a child go near a case of scarlet fever. This is especially
important to be observed.
Children are in much greater danger of death from scarlet fever than are
adults; but adult persons often get and spread the disease, and sometimes
die from it. Mild cases in adults may cause fatal cases among children.
Unless your services are needed keep away from the disease yourself. If
you do visit a case, bathe yourself and change and disinfect your clothing
and hair, beard, if any, and hands before you go where there is a child.
Do not permit any person or thing or a dog or cat, or other animal to come
from a case of scarlet fever to a child. No cat or dog should be permitted
to enter the sick room.
Do not permit a child to wear or handle clothing worn by a person during
sickness or convalescence from scarlet fever.
Beware of any person who has sore throat. Do not kiss or come near to such
a person. Do not drink from the same cup, blow the same whistle, or put
his pen or pencil in your mouth. Whenever a child has sore throat and
fever, and especially when this is accompanied by a rash on the body, the
child and attendant should immediately be isolated until the physician has
seen it and determined whether it has scarlet fever. Strict quarantine
should be established and maintained throughout the course of the disease.
Exposed persons should be isolated until such time has elapsed as may
prove that they are not infected. The period of incubation, that is the
interval of time between exposure to the contagion of scarlet fever and
the first sign of the disease in the person so exposed, varies. In many
cases it appears in seven days, in some cases in fourteen days, and in
some cases twenty-one days; the average period is about nine days.
Quarantine of persons exposed should not be raised under four weeks.
Children believed to be uninfected may be sent away from the house in
which there is scarlet fever to families in which there are no persons
liable to the disease, or to previously disinfected convalescent wards in
hospitals; but in either case they should be isolated from the public
until the expiration of the period of incubation. This time may vary, but
for full protection to the public isolation should be observed for four
Persons who are attending upon children or other persons suffering from
scarlet fever, and also the members of the patient's family, should not
mingle with other people nor permit the entrance of children into their
SANITARY CARE OF INFECTED AND SICK PERSONS AND ROOMS.
All persons known to be sick with this disease (even those but mildly
sick) should be promptly and thoroughly isolated from the public and
family. In ordering the isolation of infected persons, the health officer
means that their communication with well persons and the movement of any
article from the infected room or premises shall be absolutely cut off.
Except it be disinfected, no letter or paper should be sent through the
mail from an infected place. That this is of more importance than in the
case of smallpox is indicated by the fact of the much greater number of
cases of sickness and of deaths from scarlet fever,--a disease for which
no such preventive as vaccination is yet known.
The room in which one sick with this disease is to be placed should
previously be cleared of all needless clothing, drapery and other
materials likely to harbor the germs of the disease; and except after
thorough disinfection nothing already exposed to the contagion of the
disease should be moved from the room. The sick room should have only such
articles as are indispensable to the well-being of the patient, and should
have no carpet, or only pieces which can afterwards be destroyed.
Provision should be made for the introduction of a liberal supply of fresh
air and the continual change of the air in the room without sensible
currents or drafts.
Soiled clothing, towels, bed linen, etc., on removal from the patient
should not be carried about while dry; but should be placed in a pail or
tub covered with a five per cent solution of carbolic acid, six and
three-fourths ounces of carbolic acid to one gallon water. Soiled clothing
should in all cases be disinfected before sending away to the laundry,
either by boiling for at least half an hour or by soaking in the five per
cent solution of carbolic acid.
The discharges from the throat, nose, mouth, and from the kidneys and
bowels of the patient should be received into vessels containing an equal
volume of a five per cent solution of carbolic acid, and in cities where
sewers are used, thrown into the water closet; elsewhere the same should
be buried at least one hundred feet distant from any well, and should not
by any means be thrown into a running stream, nor into a cesspool or
privy, except after having been thoroughly disinfected. Discharges from
the bladder and bowels may be received on old cloths, which should be
immediately burned. All vessels should be kept scrupulously clean and
disinfected. Discharges from the nose, ears, etc., may be received on soft
rags or pieces of cloth and which should be immediately burned.
All cups, glasses, spoons, etc., used in the sick room, should at once on
removal from the room, be washed in the five per cent solution of carbolic
acid and afterwards in hot water, before being used by any other person.
Food and drink that have been in the sick room should be disinfected and
buried. It should not be put in the swill barrel.
Perfect cleanliness of nurses and attendants should be enjoined and
secured. As the hands of the nurses of necessity become frequently
contaminated by the contagion of the disease, a good supply of towels and
basins, one containing a two per cent solution of carbolic acid (two and
three-fifths ounces of carbolic acid to a gallon of water) and another for
plain soap and water should always be at hand and freely used.
Persons recovering from scarlet fever, so long as any scaling or peeling
of the skin, soreness of the eyes or air passages or symptoms of dropsy
remain, should be considered dangerous, and, therefore, should not attend
school, church or any public assembly or use any public conveyance. In a
house infected with scarlet fever, a temporary disinfection after apparent
recovery may be made, so as to release from isolation the members of the
household who have not had the disease.
Diet and Nursing. Food should be given every two to four hours. Only
water can be given as long as there is nausea and vomiting, and sometimes
not even that. After they have stopped you can give milk and water and
then milk. You should give it to a child every two to three hours, about
one-fourth of a glass full and warm if possible. A child can take at least
one quart in twenty-four hours. Watch the stomach and bowels for bad
symptoms; if necessary you can put in one teaspoonful of lime water after
the milk has been heated. If the child will not take milk, use one of the
prepared foods. Mellins' malted milk, Borden's malted milk, peptonized
milk, Imperial Granum, and follow the directions on the bottle. The
different food waters mentioned above are to use when milk and other food
preparations cannot be given. Albumen (white of an egg and water, not
whipped) can be given and always cold. Cold milk also tastes better.
During the Sickness, etc. The linen, bedding, etc., of the patient should
be put into a one to five-thousand solution of corrosive sublimate (you
can buy that strength tablet) before being boiled, dried and aired in the
sun. The sick room must be kept well ventilated, but no drafts should be
allowed to go over the patient. The temperature is better at 68 degrees F.
The patient should be kept in bed during all the feverish stage and during
the scaling stage also.
Care must be taken lest the patient take cold. During this time there is a
great danger of ear and kidney trouble. It would be safer to keep the
patient in bed until the peeling is done. Children are naturally lively,
risky, and a little careless. To keep the scales from flying you can
grease the patient with cold cream, vaselin, lard, etc. This will also
help to ease the itching. The peeling is aided by bathing the patient
every day with warm, soapy water.
Special Treatment. In ordinary cases little treatment is needed except to
keep the throat and nose free from excessive secretions. The urine should
be examined daily, and the bowels should move once or twice a day. Cold
water should be given frequently after the nausea has passed away. Milk is
the usual food, but must not be given during the vomiting stage. Equal
parts of milk and water can be given after the vomiting stage, if the
patient will not take pure milk.
During the vomiting stage very little water even can be given. The
greatest danger in scarlet fever comes from the throat complications and
the high fever.
When the fever is high the patient suffers from delirium. A temperature of
105 is dangerous and such patients must be bathed well in water,
commencing at 90 degrees and rubbed well all over while in the water,
allowing the temperature of the bath to fall to 85 or 80 degrees while so
doing; bath to last five to fifteen minutes. Bathe the head with water, at
the temperature of 50 degrees, all the time the temperature is at 103
degrees or higher. Always use the thermometer to determine the temperature
of the water. Weakly children often do not stand the bath well, so you
must exercise discretion in giving it often. The temperature must be kept
down to 102 to 103-1/2, and baths must be used often to do so. Where baths
cannot be used, frequent washing with water at 60 to 70 degrees must be
adopted without drying the child afterwards. A mother should always
remember that a feverish, restless child needs a bath or a good washing
with cool soap and water. If the bowels and kidneys do not act freely
enough give the following:
Epsom Salts 2 ounces
Cream of Tartar 2 ounces
Mix and give one-half teaspoonful in water every three hours until the
bowels move freely.
This is the dose for a child one year old.
Dropsy in Scarlet Fever. In this case you must have a doctor. A simple
way to make a dropsy patient sweat is to place the patient upon a cane
seated chair, pin a blanket around the neck, covering the whole body.
Under the chair place a wooden pail half full of cool water and into this
put a brick baked as hot as possible; or you can introduce steam under the
blanket while the patient is sitting on a chair, or lying in bed, taking
care not to scald the patient. This will cause sweating, and relieve the
dropsy and also congested kidneys.
How Soon May a Scarlet Fever Patient Associate with the Healthy?--It is
best to wait a few weeks after scaling ends. Give the patient a bath in a
one to 10,000 corrosive sublimate solution first.
Caution. An ordinary case of scarlet fever does not need much medicine.
Nursing and care are essential. Even the slightest case should be watched.
There is always danger of the eyes, ears and kidneys becoming affected. If
the child complains of pain in the head the ear must be examined. If the
urine passed is small in quantity, or if there are any signs of dropsy,
treatment must be given at once. You have heard very much lately about the
sting of the honey bee for rheumatism. I often use a preparation of this
for the kidney troubles in scarlet fever. The name is Apis Mel. I use the
second or third homeopathic attenuation in tablet form and give one to two
about every two hours. I have found this effective in such cases where the
urine is small in quantity, and there is some dropsy. The lightest cases
can have dropsy, especially if special care is not taken when scaling goes
I was once attending three children for scarlet fever. The one that had it
in a mild form became affected with dropsy. For this I steamed her. In her
case I placed her in a cane-seated chair, pinned a blanket tightly around
her so as to thoroughly cover her, put a pail of cool water under her
chair and dropped into the pail a hot baked brick. The hot brick caused
steam to rise from the water and enveloped the child, producing sweating.
This was done frequently, and the child considered it a joke, but it
relieved her of the bloat. It was in the country and these crude means
produced the desired result. By attaching a rubber tube to a steaming
kettle and introducing the steam under the covering the same result can be
produced. Sometimes you may not have all things you wish, then you must
make use of what is handy. You would be surprised perhaps to know how much
can be done to relieve sickness by what can be found in every house. (For
disinfectants see chapter on nursing.)