Notes on Scarlatina
Dublin Journal of Medical Science
ART. XlII--Notes on Scarlatina." By ARTHUR WYNNE FOOT, M.D. ; Junior Physician to the Meath Hospital. IT appeared to me that it might, be of interest, at the present time, to offer a few brief remarks on some points connected with scarlatina. The epidemic which has just begun to abate has furnished numerous cases for observation, and has enlarged the experience of many, while it has almost originated that of some. Among the latter class I place myself, and, therefore, I noted, with care, as
... , with care, as many eases as I had time to observe accurately, and added them to my small stock.. The object in view was not statistical in any way, but the acquisition and preservation of a personal experience of the disease. I find in my note-books 73 cases detailed in full, and of 17 others the clinical charts of temperature, &c. ; these data furnish the basis of my comments on the subject. These 90 cases, the greater number of which have reference to the present epidemic, do not, of course, include all the cases which have come under my observation, but are merely those to which I can refer with certainty as accurately noted at the time. The number may appear very small to some, but as my experience has been principally derived from the wards of the Meath Hospital, it is proper to observe that the accommodation there, in the isolated building for infectious diseases, is scanty; that many of the eases, owing to tedious'sequelae, occupied beds for a long time--50, 60, and 70 days, or more--and that many were kept in hospital after apparent convalescence, as a prophylactic measure against ulterior complications. My impression of the late epidemic is, that although the mortality in the city, in general, was large, this was rather owing to its prolongation and general diffusion than to the severity of type it exhibited; and that fatal results occurred rather from the state of health of those attacked than from malignancy in the virus. This impression is founded on three classes of observations--first, the number of deaths was relatively, for searlatina, small in the number of eases which came under my observation; in the hospital it was 9 in 73, or 12"3 per cent. ; secondly, the throat affections, and their consequences, did not seem as severe or as numerous as usual; and, thirdly, the elevation of temperature was not excessive. In reference to the first point, it is to be borne in mind that the rate of hospital mortality of scarlatina is relatively raised by the advanced a Read before the Medical Society of the College of Physicians, March lOth, 1875.