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.
[INFECTIOUS DISEASES 173]
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.
[174 MOTHERS' REMEDIES]
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.
[INFECTIOUS DISEASES 175]
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
on.
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.)
[176 MOTHERS' REMEDIES]
MEASLES.--Measles is an acute infectious disease, distinguished by a
characteristic eruption on the mucous membranes and skin. It is very
contagious and spreads through the atmosphere. Almost everyone is
susceptible to measles and suffers at least one attack. The disease is not
frequent during the first year of life. It prevails in all countries.
Incubation.--This varies from thirteen to fifteen days. In calculating
this period we include the time from exposure to the appearance of the
eruption. One attack generally protects the person from another attack.
The period of the greatest danger of taking it extends through the period
of the eruption. It diminishes as the eruption fades. From this we learn
that the infection in measles takes place generally in the incubation
stage.
Symptoms and Description of Ordinary Type.--The first symptoms may be only
a headache or a slight disturbance of the stomach. There may be some fever
in the evening. There is now a redness and watery condition of the eyes,
and general feeling of weariness. The cold symptoms (coryza) are not yet
marked, but if we look in the mouth we may see a few spots on the mucous
membrane of the cheek. Then follow the sneezing, running at the nose, sore
and red eyes; running water, sensitiveness to the light, cough and fever.
The eruption now appears, and is first noticed on the side of the head and
the wings of the nose, as a red spotted eruption, which soon looks like a
pimple, and then "blotchy." Older people feel quite sick. The aching all
over, and headache are sometimes almost unbearable, especially when there
is much coughing. The face, eyes and scalp are soon covered by the red
rose irregularly shaped pimples, which next appear rapidly on the back of
the hands, fore-arms, front of the trunk, on the back and lower
extremities. This order is not always maintained. Sometimes it first
appears on the back.
The eruptive stage generally lasts three or four days, during which time
the symptoms are all aggravated, especially by any strong light, on
account of the sore eyes for the measles are also in them. We have active
cold symptoms like sneezing, running at the nose, snorting, snuffling,
hawking. The cough is terribly severe, annoying, making the lungs and
stomach very sore. The head feels as if it would split. The patient holds
his chest and "stomach" while coughing. Symptoms of acute bronchitis
develop. Sometimes there is much diarrhea. Pneumonia often develops
through carelessness. The fever reaches its height when the eruption is
fully developed. The eruption fades after it has been out for three or
four days, and then all the symptoms decrease, the fever lessens and
becomes normal by gradual morning remissions. Scaling begins when the
pinkish hue of the rash has disappeared and continues until the last
vestige of reddish spots has disappeared. As a rule it is completed in two
to four weeks after the first eruption has appeared. Sometimes the scaling
is difficult to see, but it is never absent in measles: It is best seen on
the front part of the chest, shoulders, and the inner surface of the
thighs. The temperature may reach 104 to 105-8/10 without complications.
This description gives a picture of a typical case. The eruption that
appears in the mucous membrane of the mouth appears three to four days
before the skin rash. It is accompanied by redness of the pharynx and of
the front and back pillars of the fauces. The soft palate is studded with
irregular shaped, rose colored spots or streaks and the hard palate
presents small whitish vesicles. They are also found on the colored mucous
membrane of the cheeks and on that opposite the gums of the upper and
lower teeth. The rash of measles is a characteristic eruption of rose
colored or purple colored papules (pimples). As a rule the whole face is
covered with the eruption and is swollen. Diphtheria may complicate
measles. Bronchitis and brancho-pneumonia also may occur, especially if
the patient is careless and takes cold. Diarrhea is frequently present.
[INFECTIOUS DISEASES 177]
Eyes.--Following severe cases fear of light, spasm of the orbicularis
muscle, inflammation of the lachrymal duct, conjunctivitis, ulceration of
the cornea and amaurosis (general blindness) may result. Hence the
necessity of careful attention to the eyes. Never read anything during the
attack of the measles. The ear may also become afflicted. There are other
complications, but these mentioned are the important ones.
Mortality in Measles.--The mortality in childhood and infancy is about
eight per cent. Mortality is greatest for number of cases during the first
year. Six per cent between fifth and eighth years.
Diagnosis.--Presents few difficulties in a typical case. The mode of onset
is cold symptoms of the nose and eye, cough; appearance of the mouth,
throat and the blotchy eruptions are very characteristic.
Treatment. Prevention.--As soon as you know it to be the measles, separate
the case and put the patient in a well-aired room where you can have air
without a draft and where the room can be made and kept dark. Those
persons who must go in the room should put over them a linen robe, and
hang it outside of the sick room. It should thoroughly cover them. When
not in use hang it in the open air. An attendant who wears a beard should
disinfect his beard, face, head and hands before mingling with the well.
MOTHERS' REMEDIES.--1. Measles, Lemon Remedy from a Canadian
Mother.--"Give child all cold lemonade it can drink and keep in warm room.
This acts just as well as if the drinks are hot. We tried both on our
children and cured both ways." Don't give so much of the cold as to chill.
The cold drink makes child sweat, just as hot does. Also helps to carry
off impurities by flushing bowels, just as clear water would.
2. Measles, Elder Blossom Tea to Drive Out.--"Elder blossom tea is good
for a cold or fever. Gather the blossoms, and make a tea. Pleasant to
take. Sweeten if desired. This is also good to drive out the measles."
This remedy should be taken warm and is especially good to bring out the
rash in children. Take a teaspoonful every hour.
[178 MOTHERS' REMEDIES]
General Treatment.--An ordinary case of measles does not need much
treatment. If the patient has a high fever and is very hot and restless,
bathe with tepid or cool water every two or three hours, till the patient
becomes quite restful. Sometimes they have too much covering and that
makes them hot and restless. Remove a little at a time. Bathing will not
hurt the rash, for it can be done under the clothes and without any danger
to the patient.
Cold Drinks.--These are refreshing and beneficial, if not given too
freely. One-third of a glass of water is enough at one time, but it can be
given often, if it does not chill the patient. After the feverish days
have passed, diluted milk or plain milk can be given in greater amount.
Cough in Measles.--It is likely to be severe, straining and barking and
hard to relieve. If it is too severe you can give, for a child one year
old:
Acetanelid 1/2 dram
Dover's Powder 1/2 dram
Mix and make into thirty powders.
Give one-half powder every two hours when awake or restless.