Now Alder Smith is a reliable observer, a man of science and fact, and there is strong inherent evidence in his work on ringworm that he puts his facts fairly and squarely before his readers. This being so, it must follow that his facts should prove the constitutional nature of ringworm if such be the case.
Let us see.
ALDER SMITH’S FACTS VERSUS
ALDER SMITH’S VIEW THAT
“DECIDEDLY HEALTHY CHILDREN”
MAY BE SUBJECT TO
In the following quotations from Alder Smith’s work most of the italics are mine.
He says (pp. 29 et seq.):-
“Diagnosis of Ringworm which has Existed Some Time.
“Chronic Squamous Ringworm. “In the first place, I cannot help observing that very few medical men, either in consultation or private practice, are aware how extremely difficult some cases of ringworm are to cure; and the majority consider a case well, even when it has assumed a decidedly chronic state. I constantly have boys brought to me on their return to private schools, and very many also on their presentation for admission to Christ’s Hospital, who, while bringing certificates from medical men of the highest professional standing that they are cured of ringworm, and quite fit to mix with other children, are still suffering from a severe, contagious, and chronic form of the disease; and I have often found on inquiry, l that an opinion has been formed, and a certificate given without any special examination of the scalp, and certainly without the help of the lens or microscope. Many practitioners imagine that ringworm is cured when some of the hair is again growing freely and firmly on the part affected. This is a great mistake, as some of the most chronic and intractable cases are those in which the hair has partially grown again on the scurfy patches; but, on close inspection with a lens, some short broken-off hair or stumps may be seen scattered among the healthy hairs.
“It is impossible to speak too strongly on this point, as an outbreak of ringworm in a school is often due to the admission into it of an unrecognised case of the disease. As a rule, the trouble arises from a boy returning to school (after he has had an attack of ringworm on the head) with a certificate to the effect that he is cured, when in fact he is suffering from a chronic and contagious form of the complaint; or, from the entry into the school of an entirely unsuspected case; generally a boy, who has had a scurfy patch on his head for some time, but who is, in reality, suffering from chronic ringworm.
“Speaking from experience, after the examination of a very large number of children, both in private and for admission into Christ’s Hospital and other schools, I have found that in by far the majority of cases where a boy has had ringworm on the head within a year or two of my seeing him, the disease has not been really cured. As a rule, the treatment has been continued until some new hair has made its appearance on the patches, after which it has been discontinued, although many diseased stumps remained. When this stage has been reached, the case will often continue in the same chronic state-the patches remained about the same size, getting neither better nor worse-while the little patient, who may be certified as “perfectly well,” may be the constant and unsuspected cause of a succession of outbreaks of ringworm in a school.”
We therefore see that in by far the majority of cases certified as cured the disease has not been cured at all, but still exists as Chronic Squamous Ringworm. Hence it follows that the ordinary statistics of the cure of ringworm by medical and surgical practitioners are worthless. The cures are not real, the treatment has merely got rid of the worst of the ringwormy mould in its more gross and evident form. Even one year, even two years, after;the cure the sufferers continue to be contagiously ringwormy notwithstanding the fact that the patches have been scoured clean and the hairs have grown again.