DIET.- During the whole course of the fever, milk, either alone or with plain or soda-water, thin gruel, sago, arrowroot, yolk of egg beaten up with cold milk, grapes, oranges, and cooked fruits, should be the staple diet. The drink may consist of cold water, gum-water, barley-water, weak lemonade, etc. in small quantities as frequently as desired. As soon as the fever subsides, the patient may gradually and cautiously return to more substantial food. Stimulants are rarely necessary except in malignant cases, when wine, brandy, Liebig’s extract of beef, beef-tea, etc., may be given regularly in frequent small doses, under medical care.
PREVENTIVE MEASURES.-
1. To to adopted by the unaffected : During the prevalence of Scarlatina, a dose of Belladonna should be given, morning and night, to children who have not had the disease. The first or second dilution of the tincture is best for this purpose. Should the disease occur notwithstanding this treatment, its severity will be much mitigated. The author has great faith in the virtue of Belladonna thus used, both as the result of his own experiences, and from the testimonies of numerous confreres and correspondents.
2. To be adopted by the attendants upon the invalid : The attendant should have as little intercourse with the other members of the household as possible. She should wear over her ordinary clothes as overall which she can readily take off the hang on a peg before she leaves the sick-chamber. She should also dip her hands into a disinfectant after touching the patient, and especially before quitting the room. Condy’s fluid or Chloride of Lime – one tablespoonful of either to about a gallon of water – is usually employed for this purpose.
All excretions from the invalid should be disinfected with the Chloride of Lime solutions, and disposed of at once. All washing apparel that has been used by the patient should, on its removal, be immediately placed in a vessel containing a sufficient quantity of either of the above disinfectants, and be put out of doors as soon as possible, and afterwards boiled in the disinfectant. Woollen cloths, bedding, etc., that do not admit of being boiled, should either by burnt or fumigated by burning a sulphur candle, procurable at any oilman’s. The sick- chamber itself, when the patient is permitted to leave it, should be disinfected in a similar way, doors, windows and fireplaces having been securely closed.
16. Post-Scarlatinal Dropsy (Acute Tubular Nephritis.)
Homoeopathists may rejoice in the fact that under homoeopathic treatment this grave sequel of Scarlet fever is neither so frequent nor so intractable as in allopathic practice.
SYMPTOMS.- About the twelfth day after the subsidence of the fever, the subcutaneous areolar tissue becomes infiltrated with serous fluid; there is often frequent desire to pass water, which is scanty and high-coloured or smoky-looking or bloody, and albuminous. If examined by a microscope, the urine is seen to contain renal tube-casts. The pulse is quick, the temperature raised, it may be to 103o, the skin dry; the child is thirsty; and the body, face, and limbs are pale and oedematous. Occasionally the cavities of the body are more or less filled with fluid. When the cavity of the chest is invaded, there are the following symptoms – short, difficult breathing, violent action of the heart, increasing distress and lividity of the face, often followed by death. Occasionally the kidney complication exists from the outset of Scarlet fever, and is rather form of the disease than a sequel.
TREATMENT.- Arsenicum, Cantharis, and Terebinth, are the most useful medicines. Cantharis and Terebinth have actually produced acute nephritis. A dose of the one selected should be given every three hours.
INDICATIONS FOR THE ABOVE AND OTHER REMEDIES.
Apis.- Rapid general oedema; pale colour of the skin; scanty, high-coloured urine; swelling of the tonsils, difficulty of swallowing.
Arsenicum.- Scanty, dark-coloured or bloody urine, with general oedema and prostration.
Bryonia.- Is said to be useful in the same cases. It is probably indicated when the Dropsy has followed exposure to cold, and there are muscular pains present.
Cantharis.- For symptoms similar to those under Arsenicum, and with pain in passing water.
Terebinth.- Scanty, reddish, or dark urine.
ADDITIONAL REMEDIES.- Apocyn.- Can., Digitalis, Ferrum, Helleborus, and Hepar Sulph.
ACCESSORIES.- Warm baths, or sponging the body with warm water, in wet-pack, and drinking cold water are of the first importance; they facilitate excretion by the skin, and relieve the congested kidneys. The free action of the skin in the treatment of Scarlet fever is the most effectual means for preventing Post- scarlatinal Dropsy. Nothing secures this so thoroughly as the wet-pack. A nourishing, digestible diet is also essential to meet the exhaustion which usually exists. Finally, change of air is of great value.
17. Measles (Morbilli).
Measles is a disease of childhood, in itself not serious, but liable, from want of care and especially exposure to chill, to be complicated or followed by Broncho-Pneumonia, an extremely serious condition which may itself go on to Tuberculosis.
MODE OF PROPAGATION.- Infection. No susceptible person can remain in the same room or house with an infected person without risk of taking the disease; and it is almost impossible to isolate it is large establishments or schools. It is propagated, even after a considerable time has elapsed, by infected clothing, bedding, furniture, or wall-paper. Infection clothing, bedding, furniture, or wall-paper. Infection only ceases when the peeling off of the skin is quite complete, and when all the clothing and surroundings of the patient have been thoroughly disinfected. It is strongest during the eruptive stage, and especially at the early part of this stage.
SYMPTOMS. After about ten or fourteen days, the period of incubation, the disease is ushered in with the symptoms of a Catarrh – sneezing, running from the nose, red, swollen, and watery eyes, a hoarse harsh cough, languor, and fever, which increase in intensity. About the fourth day of the illness the eruption begins, and appears in three successive crops, on the face and neck, on the body, and lastly on the legs.
It is in the form of small circular spots, resembling flea-bites, which multiply and coalesce into blotches of a more or less crescentic form, slightly raised above the surrounding skin, so as to be felt, particularly on the face, which is often a good deal swollen. It is like raspberry in colour and turns white for an instant under pressure; a dark purple is a bad sign. It is two or three days in coming out, and remains at least three days. The fever then abates, and a bran-like scurf is gradually thrown off the skin. As the rash declines, diarrhoea sometimes occurs; this, unless very troublesome, should not be interfered with, as it is often beneficial.
The temperature reaches 103o on the fifth day, after which it rapidly declines.
DIAGNOSIS.- Measles can be diagnosed several days before the rash appears. Koplik’s spots – tiny white specks surrounded by a red zone visible with a good light on the mucous membrane of the mouth in the neighbourhood of the first molar teeth – can be detected on the first and second days of illness.
Formerly this disease was confounded with Scarlet fever, but there are well-marked difference between the two, as shown below.
18. German Measles (called also False Measles, Rubella – German : Rotheln.)
This is an infectious eruptive fever, the rash appearing during the first day of the illness, beginning on the face in rose-red spots, extending the next day to the body and limbs, subsiding with the fever on the third day, and not preceded (as Measles is) by symptoms of cold in the head, or followed (as both Measles and Scarlatina are) by shedding of the superficial skin. The disease spreads by contagion. It only attacks the same person once; but it does not protect those whom it attacks from either Scarlatina or Measles. It has a long period of incubation, usually a fortnight, but varying from seven to twenty-one days, usually its rash is the first thing noticed. There is headache, sore throat, swelling of the glands in the neck, and sharp fever. There are also, as a rule, slight catarrhal symptoms.
DIAGNOSIS.- The sudden onset of the disease distinguishes it from Measles, and the enlargement of the glands at the side of the neck. The appearance of the rash in distinct spots and on the face first, distinguishes it from Scarlatina, also the less severe sore throat, and the enlargement of the glands at the sides of the neck (and not at the angle of the jaw as in Scarlatina).
TREATMENT.- Aconite and Belladonna should be given every hour in alternation. The general treatment is the same as for Measles; and the complications (which are very rare, the disease being attended with little danger) are to be treated, as they arise, in the same way as those of Measles and Scarlatina.
19. Smallpox (Variola).
VARIETIES.- This, the most marked of the eruptive fevers, and one of the most malignant, loathsome, and contagious disease, is of two varieties : (1) the distinct, when the pustules are separate and well defined (2) the confluent, when they are thick-set, run into each other, and form continuous suppurating surfaces. In this latter variety all the symptoms are aggravated, the glands are affected, the limbs swell, the mucous membranes show the eruption, and there is danger of suffocation from involvement of the larynx. This variety is, therefore, very dangerous, for the severity bears a direct proportion to the extent and suppuration of the pustules.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."