Introduction to a discussion on the diagnosis between rubeola and scarlet fever, on May 14th, 1896 / by E.W. Goodall.

  • Goodall, E. W. (Edward Wilberforce), 1861-
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Introduction to a discussion on the diagnosis between rubeola and scarlet fever, on May 14th, 1896 / by E.W. Goodall. Source: Wellcome Collection.

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    question of length of incubation period might have saved a blunder. On May 18th three patients were sent to the Eastern Hospital certified to be suffering from scarlet fever, a young woman, aged 19, and two boys aged ten and sis. They came from the same house. Had I seen any one of these patients separately I should have hesitated as to the diagnosis. I should have said, not scarlet fever, but query whether rubeola or some non-infectious erythema. But taking the three cases together, they made a picture between them that was fairly typical of rubeola. Now, the young woman had been living in service from May 11th to May 17th in a different house from that from which she was removed. On May 17th she went to the house where the boys lived, and she had been living in this house from April 27th to May 11th, just before she went out to service. She returned to this house on the afternoon of May 17th, and she was quite positive that the rash had appeared in the morning, before she left her place of service. During the week, May 11th to 17th, she did not leave this place. The medical certificate was dated May 17th. Whatever the disease was, therefore, from which these patients were suffering, it was highly improbable that it was scarlet fever, for it would have been a curious coincidence if the young woman and the two boys had been infected at the same time in different places. Whereas, if the disease was rubeola, all three patients may easily have been infected from a common source during the early part of the fortnight, April 27th to May 11th). There is usually no prodromal period in rubeola ; but when it is present the mastoid and posterior cervical, and sometimes all the superficial glands, are enlarged. Vomiting is not present, whereas this is a very constant symptom of the onset of scarlet fever. But as the rash may appear on the first day of scarlet fever and rubeola, little help is to be gained from the absence of prodromal symptoms. The rash almost invariably—I think I may go so far as to say ‘ invariably ’ without the ‘ almost ’—commences on the face in rubeola. It then spreads to the chest and upper extremities, next to the rest of