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sick room.

Do not permit a child to wear or handle clothing worn by a person during sickness or convalescence from scarlet fever.

Beware of any person who has sore throat. Do not kiss or come near to such a person. Do not drink from the same cup, blow the same whistle, or put his pen or pencil in your mouth. Whenever a child has sore throat and fever, and especially when this is accompanied by a rash on the body, the child and attendant should immediately be isolated until the physician has seen it and determined whether it has scarlet fever. Strict quarantine should be established and maintained throughout the course of the disease. Exposed persons should be isolated until such time has elapsed as may prove that they are not infected. The period of incubation, that is the interval of time between exposure to the contagion of scarlet fever and the first sign of the disease in the person so exposed, varies. In many cases it appears in seven days, in some cases in fourteen days, and in some cases twenty-one days; the average period is about nine days. Quarantine of persons exposed should not be raised under four weeks.

[172 MOTHERS' REMEDIES]

Children believed to be uninfected may be sent away from the house in which there is scarlet fever to families in which there are no persons liable to the disease, or to previously disinfected convalescent wards in hospitals; but in either case they should be isolated from the public until the expiration of the period of incubation. This time may vary, but for full protection to the public isolation should be observed for four weeks.

Persons who are attending upon children or other persons suffering from scarlet fever, and also the members of the patient's family, should not mingle with other people nor permit the entrance of children into their house.

SANITARY CARE OF INFECTED AND SICK PERSONS AND ROOMS.

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

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