Epidemic of scarlet fever at Donaldson's Hospital during the autumn and winter of 1861 / by James D. Gillespie.

  • Gillespie James D. (James Donaldson), 1824-1892.
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Epidemic of scarlet fever at Donaldson's Hospital during the autumn and winter of 1861 / by James D. Gillespie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    12/18 (page 12)
    The cases in which the attack of the disease was a second one were Nos. 4, 17, 23, 24, 25, 26, 33, 34, 39, 41. In only one of these, No. 4, was the ordinary scarlet eruption visible. In three of them Nos. 23, 39, and 41, there was absolutely no eruption ; in the others, merely slight mottling of chest. In all of them, however, there was the characteristic tongue, and more or less fever. In two cases, Nos. 34 and 41, extreme sickness was present: in the former terminating in vomiting and prostration, from which, however, the patient soon rallied; while in the latter, the sickness, though not attended by vomiting, was marked by what proved a much more serious symptom,—intense pain of the head, with extremely rapid feeble pulse. Before leaving the subject of a recurrence of scarlatina, I may draw your attention to two facts,—1st, That my experience shows that when an epidemic of scarlatina breaks out among a large collec- tion of .people, chiefly children, resident in the same building, the morbid poison affects with different degrees of intensity a con- siderable number of those who had previously passed through the disease ; 2d, That having previously had scarlatina does not afford absolute protection from a fatal issue to those who a second time suffer from the complaint. In a clinical essay on scarlatina, published lately by Dr Richard- son in the Asclepiad, he says, u I take it, nevertheless, that the phenomenon of recurrence is most exceptional; and it is satisfactory to know that I can discover neither in literature nor in general experience one single case in which a second attack has proved fatal.”1 Case 41 will, I trust, prove that no certainty of immunity from a fatal issue to a second attack exists, though such an occur- rence must be very rare, seeing that Dr Richardson, in the course of extensive practice, and after much research, has not met with such a case, I have it on very good authority,—the testimony of his grandmother and aunt,—that a few years ago the poor boy, J. W. (Case 41), who was lately cut off by scarlatina in the hospital, nearly died of the disease, another child in the family also hav- ing it very severely. The father and mother being absent in the United States prevents my being able at present to corroborate by their evidence the truth of these statements. With regard to the frequency of recurrence, the fact of ten out of the forty-three cases enumerated, having previously had the disease, shows that such cases are not so exceptional as has been stated. It may be argued that these second attacks are not true instances of the disease. To such arguments I would say, read the cases of primary and secondary invasion, and then point out what dif- ference, save perhaps in degree, exists between them. I am ready to admit that some of the cases entered as scarlatina, if taken separately, might be denied the privilege of ranking as such ] but no one who reads the short notes of all the cases I have jotted 1 Asclepiad, p. 73.