i8o 



SCIENCE. 



[Vol. XI. No. 271 



own board of health, and the secretary of the State board of health, 

 •constantly informed respecting every outbreak of scarlet-fever, and 

 ■of the facts, so far as the same shall come to his knowledge, re- 

 specting sources of danger of any such diseased person or infected 

 article being brought into or taken out of the township, city, or 

 village of which he is the health-officer. 



The spread of scarlet-fever can generally be prevented by the 

 plan of prompt notification, thorough isolation, and complete dis- 

 infection of all infected substances. But when this plan has come 

 into general operation, there is needed a plan for the prevention of 

 the introduction of the disease from without the jurisdiction. 

 ■Quarantine officers should be required to be as watchful and strict 

 to prevent the introduction of scarlet-fever as of small-pox, because 

 the loss of life by scarlet-fever is many times greater than by small- 

 pox. For results of perfect and of imperfect compliance with this 

 plan, see the diagram (A) presented herewith ; see also Proceedings 

 ■of Michigan State Board of Health, January, 18S7, where it is shown 

 that there was a probable saving of 3,718 lives from this one dis- 

 ease in the first eleven years after the adoption of this plan by the 

 Michigan State Board of Health. 



Probably much may be done to prevent well persons from con- 

 tracting scarlet-fever when they are exposed to it. Statistics seem 

 to prove that the rise and fall of this disease are controlled by the 

 temperature and humidity of the atmosphere ; scarlet-fever rising 

 after the temperature falls, and falling after it rises. The reasons 

 why are stated in Dr. Baker's paper on ' Some of the Cold Weather 

 ■Communicable Diseases ' (with diagrams), in the Transactions of 

 the Michigan State Medical Society, 1887. 



A very great number of reports have been received by the Mich- 

 igan State Board of Health from reliable physicians, stating facts 

 which show that scarlet-fever is conveyed by "direct communi- 

 cation," " exposure while visiting," etc. 



The following statements are taken from the reports of the 

 health-officers to the Michigan State Board of Health, showing that 

 scarlet-fever may be conveyed by clothing, etc., and after a long 

 period of time has elapsed since the first case occurred (with the 

 •name of health officer and locality subjoined): — 



"A man living in Detroit who has a child living in this neighbor- 

 hood came to see her, and in a short time the little girl was sick of 

 scarlet-fever. It was ascertained that he had been living with a 

 family who were afflicted with the same." — Dr. S. HOLCOMB, 

 health-officer, Southfield Township, Oakland County. 



" By the presentation of the dress of a little girl who died at 

 Jackson to a little girl living here." — Dr. SAMUEL DuBoiSE, 

 Unadilla Township, Livingston County. 



" A woman brought the disease from Canada in her clothing, 

 and gave it to the children where she staid. Case No. i took it 

 then, and case No. 2 took it from the children at school." — E. F. 

 Wood, health-officer, Isabella Township, Isabella County. 



" The only source of contagium that I have been able to discover 

 was through letters received from a family residing in Mount 

 Pleasant, which was then affected with it." — Dr. J. P. COOPER, 

 health-officer, Ithaca Township, Gratiot County. 



" I have but one case of contagious disease to report this week, 

 •that of Miss N. F., age seven years. The source of contagium is 

 peculiar. Miss G. H., of Grass Lake, Jackson County, Mich., sick 

 ■with scarlet-fever, wrote a letter to the mother of this patient, and 

 she (the little girl) had the envelope in her mouth. Seven days 

 later she came down with the disease. It seems certain that she 

 •contracted the disease in that manner, as there is no other way 

 that I can account for the appearance of the disease in that part of 

 the township."— Dr. H. C. Maynard, health-officer, Hartford 

 Village, Van Buren County. 



"Last June one of Mr. More's children had scarlet-fever. 

 Strange to relate, but one of them had it. The loth of this month 

 [November] the carpets were taken up, and Fannie, and Lulu, a 

 ■cousin living near by, romped and played on them while in the 

 yard. In a little over a week both of them were taken sick with 

 scarlet-fever. No precautions were taken after the case had oc- 

 ■curred last June, and hence the outbreak nearly four months after- 

 wards." — Dr. M. E. Bishop, health-officer. South Haven Village, 

 Van Buren County. 



The 'Report of the Michigan State Board of Health for 1884' 



contains, on p. 276, the following accounts of methods of spread of 

 scarlet-fever : — 



Dr. A. L. Ambrose, health-officer of Hanover Township, Jack- 

 son County, reported three cases of scarlet-fever where the source 

 of contagium was a washtub which had been used several weeks 

 previously by a family having the scarlet-fever. In four cases the 

 contagium was left in houses that had not been properly disinfect- 

 ed. In one case the germs of the disease remained in the bed- 

 ding that had been used by a scarlet-fever patient six or seven 

 months previously. In one case the disease was taken from " old 

 rags of eighteen to twenty months' standing." 



Nov. ig. Dr. N. W. Andrews, health-officer of North Muskegon, 

 writes, " There was, some six or eight months ago, a mild case of 

 scarlet-fever in the adjoining house : at the time, the people who 

 now have the case had some household furniture stored there, 

 which has lately been moved into their own house. I can find no other 

 cause for the outbreak than that the contagium was communicated 

 by means of the tapestry, which had been stored in a room where 

 the child when sick had been allowed to go." 



The following interesting statements are extracts from a letter 

 received Aug. 23, 1884, from Rev. Fayette Hurd of Grand 

 Blanc, Mich., giving facts concerning scarlet-fever near the village 

 of Laingsburg, Shiawassee County, during the month of December, 

 1880: — 



" About Dec. 20, 1880, the family were in the garret of the house, 

 gathering up rubbish that had been collecting there for some time. 

 They put into a basket to be burned a number of magazines, pic- 



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All (324) 



Isolation or Disin - 



Isolation or Disin- 



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fection Doubtful. 



fection Neglected, 



fection Enforced. 



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Deaths. 



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tures, pieces of cloth, window-curtains, carpet-rags, and an old 

 rubber doll, which belonged to a family that had the. scarlet-fever 

 in the same house during the winter of 1S74-75. The boys gath- 

 ered up a good many of the pictures, and the girl took the doll, which 

 belonged to the child who had the disease in 1874, and was, I 

 think, used by her when sick with scarlet-fever. The curtains were 

 hung in the windows of the room during the sickness in 1874-75. 



