i6 



SCIENCE. 



[Vol. XI. No. 258 



but was not sick enough to necessitate calling a physician. The 

 grandmother wore nearly the same clothing while on her visit that 

 she had when attending this previous case. The other eight cases 

 of the eleven probably took the disease from the first three, since, 

 owing to the size of family and their circumstances, satisfactory 

 isolation could not be had ; and I know of no other cases in the 

 vicinity." 



Dr. Morgan recommends to disinfect discharges from bowels, 

 bladder, and throat by adding an equal volume of solution of corro- 

 sive sublimate (i to 500); to anoint the skin daily during desqua- 

 mation stage, so as to diminish the risk from fine scales of epider- 

 mis floating in the air ; to bathe frequently the skin during that 

 stage, and to disinfect the water so used by adding an equal vol- 

 ume of the corrosive-sublimate solution ; to disinfect bedding, 

 clothing, etc., by soaking in a solution of corrosive sublimate (i to 

 1,000) or by prolonged boiling in water; to disinfect rooms, etc., by 

 burning dust and sweepings, washing wood-work, etc., with cor- 

 rosive-sublimate solution (.1 to 1,000), and by thorough fumigation 

 with sulphur-fumes finally ; to forbid nurses or members of the 

 family attending the sick to mingle with others without first disin- 

 fecting their hands, etc., and changing their garments worn in con- 

 tact with the sick ; lastly, to forbid public funerals for those dying 

 of scarlet-fever. He further says, " Where I have succeeded in 

 having these measures carried out, I have never known the disease 

 to spread further. Beyond thorough ventilation of apartments, 

 and disinfection as above recommended, only such measures as are 

 calculated to promote health and bodily vigor will be of any service 

 to prevent the well from contracting the disease when exposed to 

 it. The use of belladonna, camphor, etc., as preventives, I believe 

 to be utterly valueless, except, perchance, for the mental effect upon 

 those having exaggerated fears of the disease. Aside from the 

 cases usually cited in text-books, a case of interest was reported in 

 the London Lancet of April 11, 1868, I believe. A domestic ser- 

 vant died of scarlet-fever of very malignant type, after which the 

 doctor gave directions for the most vigilant care in purifying the 

 room and its contents, bedding, clothing, etc. ; all which directions 

 were strictly carried out, except with regard to the blankets, which, 

 as the young and newly married mistress objected to the conversion 

 of new blankets into old ones by the process of scouring, were put 

 away uncleansed in a wardrobe in a vacant room. ' Fourteen 

 months afterwards, this young housekeeper, expecting her first 

 confinement, whilst providing a temporary bed in her room for the 

 accommodation of her monthly nurse, took these identical blankets 

 from their resting-place as a part of the covering for it. About a 

 fortnight after making this provision, her labor not having come on 

 in the interval, I was requested to visit her. I found her under 

 scarlet-fever of the most severe form. In four days parturition com- 

 menced, and she died from exhaustion in half an hour after the 

 birth of her child.' " 



James P. Marsh, M.D., Green Island, N.Y., gives the following 

 from his case-book: "Feb. 3, 1887, Miss M., aged eighteen, came 

 down with scarlatina, which ran a moderately severe course. On 

 Feb. II, 1887, her nephew, aged five years, came down with the 

 disease, which ran a mild course. Through the whole of his aunt's 

 illness, he was constantly in the room with her, from certain circum- 

 stances isolation being impossible. At no time after the beginning 

 of her illness was he out of doors, hence there was no other source 

 of exposure." Dr. Marsh refers to the following articles : ' Practical 

 Considerations Regarding the Acute Infectious Fevers, especially 

 Scarlet-Fever' (Gaillard's Monthly, vol. xi. p. 427), 'The Source 

 of Infection and Limits as to the Time of Infection of Scarlet-Fever 

 and Measles' {New York Medical Record, vol. xfivn.-p. 612), 'Tiyira.- 

 tion of Contagiousness after Scarlet-Fever ' ( Transactions of the 

 New York State Medical Association, vol. i. p. 73), ' Duration of 

 the Infectious Period of Scarlatina ' {New York Medical Joiir7ial, 

 vol. xiv. p. 278). 



A. Vanderveer, M.D., Albany, N.Y., reports that healthy children 

 carried in a carriage that had the day before contained cases of 

 scarlet-fever, sickened with the disease in due time. 



Wmslow Anderson, M.D., San Francisco, Cal., writes that on 

 several occasions, when his patients have been visited while suffering 

 with scarlet-fever, the visitors have carried the disease several miles, 

 and communicated it to children. 



Thomas F. Wood, M.D., Wilmington, Del., says, " My children 

 played in a room where some clothing was being quarantined be- 

 cause of a suspicious eruptive disease which was too light to be 

 called scarlet-fever. The boy who came first in contact with the 

 clothes was seized, and two others took it from him." 



A. R. Hopkins, M.D., Buffalo, N.Y., relates an instance in which 

 a child, ill with the disease, sent a book from its bed to a neigh- 

 bor's, the only direct communication between the houses or fami- 

 lies. The disease followed the book in five days. In another in- 

 stance a stuffed chair from a nursery where the disease had beer> 

 present six months before, was sent by express to a house miles 

 away, where no fever was, or had been, in years. The disease 

 followed the chair in less than two weeks. 



Samuel B. Ward, M.D., Albany, N.Y., says, " Many cases have 

 occurred in my practice where one child in a family would catch 

 the disease from some known exposure, outside the house, and 

 within a week other children in the house would take it from the 

 one first affected. N. W., aged eight, was taken with the fever. 

 Three or four days later, A. W., her sister, aged six, took it, the 

 two having slept together before the first was taken ill. The 

 baby, aged two years, was promptly isolated, and escaped for six 

 weeks. Through the carelessness of a nurse he then one day ran 

 downstairs — or rather crept down — into his sick sister's room, 

 came down three days afterwards with the disease, and died of it. 

 E. K. aged five, and L. K. aged three, were attacked at nearly the 

 same time with scarlet-fever. The baby, aged eighteen months, 

 was spending the day with a friend when the discovery was made, 

 and did not return home for two months. In the mean time the 

 other two children recovered. The utmost care was taken with 

 the disinfection of the house by burning large quantities of sulphur 

 with all openings closed, scrubbing the wood-work and floors with 

 bichloride of mercury, leaving all windows open for twenty-four 

 hours after fumigation, washing all bedding and clothing in car- 

 bolic acid, etc. After the house was thoroughly warmed again, — 

 it was in winter, — the baby was brought home, took sick with the 

 fever within a week, and died of it. Could the wall-paper have 

 retained the contagion ? It was thoroughly swept down, but not 

 removed." 



Dr. Ward encloses to us a letter which he has received, and 

 which sufficiently explains itself : " The case you refer to, in your 

 note to me, was that of my daughter, who, in the summer of 1874,. 

 after a sojourn of seven weeks at the cottage occupied by my fam- 

 ily, and while still there, broke out with scarlet-fever. She had not 

 been away from the place from her arrival there up to the time she 

 was attacked. There was no other case of scarlet-fever at the 

 hotel, or in the cottages connected with it, during that summer. It 

 seems that the family — friends of ours — occupying the cottage 

 contiguous to the one occupied by my family, had, during the win- 

 ter and spring months just preceding, suffered severely with 

 scarlatina maligfta, losing one child from among those attacked. 

 In the month of August, about the middle of the month, it is usual 

 to experience at this place a cold storm, generally of three days' 

 duration, when heavy winter clothes are necessary to comfort. 

 Our friends in the cottage contiguous, being habitues of the 

 place, like ourselves, were well provided in this respect, and, 

 during the prevalence of the storm of that year, clad themselves 

 and their children in their winter garments. Dr. Budd, pro- 

 fessor in the Medical School of the University of New York City, 

 now deceased, who attended my daughter, had no doubt that my 

 daughter contracted the disease from absorbing the germs quies- 

 cent in the woollen winter garments of the children of our friends, 

 with whom my daughter was a constant playmate. The disease in her 

 case, however, though well defined and the eruption profuse, proved a 

 light one, I being able to bring her home on the eleventh day from 

 the first appearance of the disease, without any unfavorable resulting 

 consequences. During the continuance of the illness, every window 

 in my cottage was kept open, save those in my daughter's room, 

 both night and day; the door of her room remaining likewise open, 

 thus admitting freely the sea-wind, whether violent or mild. At one 

 period of her illness there was an incursion of mosquitoes, continu- 

 ing for several days, so dense that lamps were not lit, and guests 

 moved around or sat about with handkerchiefs upon their heads ; 

 the curious fact of which circumstance, however, was the fact that 



