View report page

NOTES ON INFECTIOUS DISEASE.
Whilst in recent years the incidence of smallpox and
enteric (typhoid) has been reduced almost to a minimum,
and that of Tuberculosis is lessening—diphtheria and scarlet
fever are as prevalent as ever, the former often virulent in
type, the latter usually mild, and we as Sanitarians have to
acknowledge that our efforts have failed in spite of careful
isolation and disinfection of the patient and his surroundings.
It is true that time is often lost before a case of infectious
disease is recognised by the friends and seen by a doctor.
The premises and relatives becoming infected before isolation
is ordered.
It is now generally believed that ordinary disinfection as
usually carried out is of no great value; it may, indeed, be
worse than useless if it is so much relied on that no cleansing
or spring cleaning is thought necessary. At the same time
I am not one of those who would regard our present method
of disinfection as unnecessary or pure "eyewash" if
properly supported by other measures. It is wiser, no doubt,
to repaint and repaper a room after use by a consumptive,
diphtheritic or a scarlatinal patient, but we cannot insist upon
it. Thorough cleansing of every part of a room and
furniture, and an exposure to sunlight would be very
effectual domestic disinfection.
Then it must be remembered as regards scarlet fever
that it is often most difficult to diagnose and is often missed
by parents altogether. There may be sore throat and little
else (Scarlatina sine eruptione) or only a slight peeling subsequently
(Scarlatina latens).
The disease as we see it now (Scarlatina simplex) is
gradually through generations becoming attenuated, and
usually is not serious, but I remember in the 70's, 80's and
90's when whole families of children would be wiped out with
(Scarlatina maligna) a horribly septic form, obvious on the
3rd day and fatal in the 5th, 6th or 7th, the little patients
becoming dried up with toxœmia. We need to be much
more active to the necessity for prophylactic measures, as
soon as infectious disease is suspected, cover the patient with
eucalyptus Vaseline (1 in 8), take swabbing of the throat;
and isolate at once, avoiding personal contact. I imagine
it will take quite three more generations before scarlet fever
will be regarded as unimportant. What is serious at the
moment is the increased number of mastoid abcesses due to
the streptococcus germ in the discharging ears penetrating
64