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the family cannot in any way be separated or removed, so that the
complaint spreads by infection, becomes distributed over the house,
then over the court, and the unaffected children or those which have
suffered mildly, going to school or playing with other children, spread
it all over the .neighbourhood.
Moreover, parents will not take any care, or adopt suitable precautions.
They say " it is only Scarlet Fever." With Typhus, which
I have shown is far less fatal, every care is usually taken ; the mere
mention of the name is enough to frighten the parents and friends of
patients into adopting the most important precautions, and the landlords
into carrying out any sanitary improvements. If any real good
is to be done in arresting the fearful mortality caused by this complaint,
we must have Scarlet Fever Hospitals in every parish; and a law
enforcing the removal of such cases as may be required. Moreover,
the most rigid attention must be paid to ensure that no child belonging
to a family, where Scarlet Fever is prevailing, shall attend school.
As I pointed out years ago, schools are powerful agents in disseminating
these infectious disorders, and when the new School Act comes
into operation, ten times more care will be required than at present.
All we can do now is to supply disinfectants to those who
require them; and to see that no tenements where the disease has prevailed,
are re-let until they have been fumigated and thoroughly
purified. This is done.
A very powerful check to the diffusion of this and other zymotic
diseases, would be to have a piece of black cloth tied to the knocker
of every house where those diseases exist; so that every one entering
or leaving the house may be reminded that they are in danger of
acquiring or distributing mortal disease. A black flag put out of the
first-floor window, was used in 1854, when the cholera prevailed,
with good effect.
I should be very glad to see the walls of all rooms occupied in
part or entirely as sleeping rooms, coloured in distemper. This could
easily be cleaned and re-placed in case of infectious disease, and would
afford no cover for vermin; in regard to both which respects, papered
rooms are exceedingly objectionable. Lithographs and engravings
are now so cheap, that a room can be made cheerful and ornamental
by them, without the pattern of paper.
Another serious point in regard to the diffusion of Scarlet Fe\er
and other infectious diseases, is that the washing of the linen among
the more well-to-do classes, is almost invariably "put out. ^ So that,
wherever the infected clothes are taken to be washed, the diseases aio
certain to be diffused. Again, when the clothes of a healthy fann y are
sent to the wash, they are liable to be mixed with those impregnated
with infectious disease, so that the clean clothes may easi y c on\ e}
infection. Unless these domestic arrangements are entirely altered,
and placed under supervision, we shall never material y ie uco t ie
mortality from these diseases.