The infectivity and management of scarlet fever / by W.T. Gordon Pugh.

  • Pugh, William Thomas Gordon, 1872-1945.
Date:
1905
Catalogue details

Licence: In copyright

Credit: The infectivity and management of scarlet fever / by W.T. Gordon Pugh. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    8/24 (page 8)
    tlio f<act tliat rhinitis often co-exists witli the otitis (nV//* Pro- fessor Simpson’s table), and tlie clitTerence is not sufticientlv ^reat to enable one to say that otorrhma |)lays a very ini])ortant i)art in tlie causation of return cases. Since otorrhoca. for anatomical and pathological reasons, fre- (piently persists for a long time after the original infective process, with which it was associated, has disa])peared. this observation is of considerable interest. It may he debjited whether the fact that otorrhma is less infectious than rhinor- rhcea residts from the s])ecific contagium being frerpiently wanting in the secretion, or because with ordinary precautions there is less risk of the discharge being brought in contact with the mucous membranes of other children. Desquamation. — Against the infectiousne.ss of sec- ondary peeling and late descpiamation of the feet, there hu'< been accumulated a considerable amount of evidence : for exa!U])le. at Birmingham, during lS9b-0S. while S *2 per cent, of all })atients left with some late peeling of the feet, only 7 ]>er cent, of alleged infecting cases had exhibited this condition on discharge. The imiuession that even earlier desquamation is not infectious has been gaining ground for several years, but definite information on this ])oint is not yet very extensive. In 1805 I)I-. Boobbyer* stated that his ex])erience as medical officer of health led him to believe that too much importance had been attached to risk of infection from desquamation. He ])ointed out that the disease fie(jut‘ntly failed to spread from an actively des<pmm.ating ])atient (though surrounded by susce]itible ])ersons), if the mucous surfaces had been only slightly invaded. Dr. Meiedith Bichaids.t then su])erin- tendent of the Birmingham Pever Hos])ital. also expre.s.sed the o])inion that desipiamation was sim]dy concomitant and not the essential cause of infection. Dr. (Jilbert,J of Tunbridge Wells, reiuarked that for twenty years he had acted with success on the conviction that iti a des(|uamating skin after scarlet fever there was no danger to others, and that if throat and nose were (piite sound, isolation of the patient was not necessary for more than a month. Di-. Priest ley, § in the same year, recorded that at Leicester, at the time of an outbreak of small]mx. about l*20 children in various stages of descpiamation after scarlet fever were .sent to their homes, and no secondary cases occurred at any of • Tax.,'It. t Put. Jour.. .Voff. 31. tSS.*>. ti. :.LM.