The hygiene of the infectious fevers / by J.W. Miller.

  • Miller, J. W.
Date:
1880
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Licence: Public Domain Mark

Credit: The hygiene of the infectious fevers / by J.W. Miller. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    the shortest limit that can be assigned, and that in typhoid fever the power of communicating infection often continues long after convalescence. Of tliis disease Aitken expresses the same opinion. Eegarding typhus, Murchison ^ considered the contagfon to be strongest from the end of the first week up to convalescence, when the peculiar odour from the skin is strongest, and that the body ceases to give off the poison as soon as the fever subsides, and the appetite and digestion are restored ; and that during the first week there is little danger. He does not say that there is none. As to measles I have already quoted Page and Stephenson. On the margin of his pamphlet kindly sent to me by Dr Squire, he writes, that three weeks of convalescence, calculated from the cessation of the specific febrile action, would suffice. Prudence might suggest that an additional week should be allowed. This would give five or six weeks from the commencement of the illness. It is generally considered, and with much reason, that it is nearly hopeless to attempt to limit measles in a family ; but Squire states,^ that when children have been kept apart during the earlier stages of measles the limitation of the infection is possible. It is surely desirable to attempt limitation, for this disease causes many deaths, the annual mortality in England alone having been as high as 12,255; and the lowest since 1850 having been 4895. In Scotland during 1876 it was 1241. But scarlet fever is in this connexion beyond question the most important of these diseases, both on account of its great fatality, and the frequency of sequelse often entailing life-long infirmity and disablement. In 1878, 18,842 lives perished from this cause in England; in 1870 the number reached 32,543. In Scot- land during 1876 it was 2364. The infection is also very intense and persistent. Thomas says ^ that the shortest exposure may suffice, and quotes in proof, that a mother after remaining only a moment with a scarlatinous patient, immediately returned home, a distance of about six miles, but communicated the disease to her children. He considers the contagium less volatile than that of measles, and that it consequently spreads less rapidly through a house.* He says that it is certain that the contagiousness diminishes as health becomes restored, but it is impossible to say when it ceases. ^ He doubts that the contagium is exclusively or even chiefly contained in the desquamating scales of epidermis, and states that it may be presumed that it enters from the blood into all secretions and excretions of the patient. It appears to me that Gee puts the matter correctly when he states his opinion, that the disease does not cease to be contagious till those natural fomitcs, the epithelial scales, which were existing at the time of the fever have been removed; or, what is nearly ' Oip. cit., p. 93. * Period of Infection, etc., p. 17. ' Ziemssen's Cycloii.,\iAA\.\i. 164. Loc. cit. ^ Op. cit., p. 172. Reynolds's System of Med., vol. i. p. 33.