A contribution to the natural history of scarlatina derived from observations on the London epidemic of 1887-1888 ...

  • Gresswell, D. Astley (Dan Astley)
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: A contribution to the natural history of scarlatina derived from observations on the London epidemic of 1887-1888 ... Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    blinds kept down, a measure ^, I think, of some value in the treat- ment dui-ing the pyrexial stage. The patients were covfned to bed, all of them, for a minimum period of twenty-two days following: upon admission ; and all, save those who were transferred (as soon as thought prudent after being allowed to get up) to the Con- valescent Hospital at Winchmore Hill, remained in hospital at least eight weeks. The diet during the first twenty-two days after admission consisted of milk, eggs, and half a pint of beef tea ^ daily, the milk practically iu any quantity. Baths were not given during the first three weeks while in hospital, except under special circum- stances. They were administered at a temperature of 98° to 100° F. in instances of pyrexial sleeplessness and deliiium, in instances of cutaneous itching attending the eruptive stage, and in a few in- stances in which desquamating epidermis did not fairly readily come away. Beyond this, bathing was not adopted during the first three weeks in hospital. After a patient, however, had been allowed to get up for three days, warm baths were given every evening immediately before going to bed. In no case was any medicament applied to the surface of the hody, save for a few applica- tions of mustard over enlarged cervical glands. Medicinal treatment was in chief part directed to regulating the bowels by means of Colocynth, Castor oil, and the tinctures of Catechu and Kino. Save in exceptional cases medicine for other purposes was not given unless it were as a placebo, two or three drops of Spiritus Chloro- formi to three ounces of water in the day. Oxygen inhalations and oxygenated water were, however, freely administered to eight October and four November patients, as recorded in the Practitioner for October and November, 1888, but, if at all, only scantily to * In the ' British Medical Journal' of July 26, 18S4, I showed that sudden ex- posure of the eyes to tropical light caused an acceleration of the puLe at the rate of as many as 300 beats per hour in a healthy man aged twenty-one years. Daylight of our latitudes may also perhaps enhance the acceleration of the pulse of a febrile per- son. Certain it is that some scarlatinal patients while febrile greatly prefer to have the light of day subdued, though there be no perceptible conjunctivitis. '■* The beef-tea for each patient's daily ration was prepared from |lb. of meat with bone; and it is, I think, of importance to mention that it was strained, so that the muscle- and bone-extractives would be relatively much in excess of the proteid matters. I have always looked with apprehension upon the use of strained beef-tea for this reason ; and there is the greater room for such apprehension, when it is ad- ministered to persons suffering from pyrexia, especially when there is a tendency to renal determination, or to depression of the heart's action.