Essays in preventive medicine : infection and disinfection : the health of children, and the period of infection in epidemic diseases / by William Squire.

  • Squire, William
Date:
1887
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Licence: Public Domain Mark

Credit: Essays in preventive medicine : infection and disinfection : the health of children, and the period of infection in epidemic diseases / by William Squire. Source: Wellcome Collection.

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    infectious from person to person, that we-should soon do away with scarlet fever by care as to cows, or drinking no milk tliat lias not been boiled. The real utility of this discovery rather lies in the fact, that, having the microscopic agent of the disease directly under observation, we can ascertain ^\•hat circumstances are inimical to its activity, and how it can best he destroyed. Isolation of the sick and convalescent, varying in time and degree with the nature of the disease, and disinfection chiefly personal are our two great means of controlling the spread of infectious fevers. It may he premature to attribute the recent remarkable reduction in our small-pox and scarlet fever epidemics exclusively to our increased means of isolation, but it is well to call attention to the coincidence. The first action of the London Asylum Board Hospitals was to reduce the small-pox mortality in London from 7,912 in 1871 to 113 in 1873, or lower than ever before, and in 1874 and 1875 to 57 and 46 ; it was only 24 last year. The annual Scarlet Fever mortality in London, for'the years 1875 and 1880 exceeded 3,000; in 1884 it was reduced to less than one half this, and for 1885 and 1886, the average is 700, the hospital accommodation for these cases having increased at the same time fourfold. This, and no vague general cause, is to be assigned for the remarkable decrease in scarlet fever in London. While declining in one place, even now the disease is seen to be increasing in another. rT'lKB results obtained in our largest communities towards the control X of Scarlet Fever raise two questions. First, can much in the same direction be done for the protection of our villages, schools, and families ? Second, how far might what is trustworthy and possible in our large towns fail us at home, or be inapplicable in detail to the smaller units of the community. The room for doubt on this latter point is small, when we consider that the natural history of the disease has been gathered from the collection of individual facts, and bv observations made in families; and, that having proved the validity, on a large scale, of the laws thus deduced which govern the spread of Scarlet Fever, we can the more confidently apply them to special cases in limiting infection. As infection is reproduced in the sick, and spreads from them, all effective measures of disinfection should begin at the bed-side, and follow the sick person; consequently the answer to the first question must be largely in the affirmative. Six weeks is the shortest period in which simple cases of scarlet fever can be considered free from infection. Some careful observations on convalescents as to the period of infection in epidemic disease ])idfiislied more than twelve years ago* by the author, showed that persons recovering from scarlet fever, and a])parently well, had imparted the disease to others six weeks, or, with certain complications, for a much longer period, after the commencement of tlie attack. Abundant proof of this has since accumulated^ * Transactions of the Epidemiological Society of London, Vol. III., p. II3.