Children's Common Diseases by Eulalia S. Sisley-Richards

Review and Herald Publishing Association · Washington, D. C. · Feb 4, 1904

Children's Common Diseases

By Eulalia S. Sisley-Richards

Scarlet Fever and Measles

EULALIA S. SISLEY-RICHARDS, M. D.

During the winter months these acute infectious diseases are most prevalent. While it is needless to say that a child suffering from either of these diseases should be under the care of a physician, this point should be emphasized, that very much depends upon good nursing and the care with which the physician's instructions are carried out.

Both of these diseases, though not necessarily dangerous in themselves, are frequently followed by serious complications, a fact which renders care and vigilance absolutely necessary. It would be well for every mother to be somewhat informed concerning the nature of these diseases, and the complications which are most likely to follow.

Scarlet fever occurs most frequently in children under ten years. The onset is usually sudden, and may be accompanied by vomiting or even convulsions. The fever rises rapidly, reaching perhaps one hundred and four degrees or one hundred and five degrees Fahrenheit the first day. Usually on the second day the scarlet rash appears, first on the face or chest, but often rapidly invading the entire skin. After a few days the rash gradually disappears, and with it the fever. At the same time the superficial layers of the skin begin to be thrown off in dry scales. This process lasts from two to three weeks. One of the most characteristic symptoms of scarlet fever is inflammation of the throat. It may be but a slight affection, or it may develop into a most intense diphtheritic inflammation.

Inflammation of the kidneys (or acute Bright's disease) often sets in during the second or third week of the disease, and is a serious complication, as it may become chronic, or even cause the child's death. The symptoms are puffiness of the eyelids, swelling of the feet, suppression of urine or the passage of a small quantity of highly colored or bloody urine. Strange as it may seem, the most severe inflammation of the kidneys often follows the milder attacks of scarlet fever. So during convalescence, even in mild cases, mothers should guard the little patient most carefully from exposure to cold or dampness, as such exposure may bring on this complication even after all danger is apparently past. In case it appears, the patient should drink an abundance of plain water or lemon water (from six to eight glasses daily). He should also be given a full hot bath or a hot blanket pack. The bowels must be kept open, and the skin active. Prolonged chilling of the skin must be carefully avoided.

For the relief of the tonsilitis, give hot fomentations to the throat every two hours, with cold compresses frequently renewed between. The throat should be frequently gargled with hot water or some mild disinfectant solution. This is very important, as the inflammation often passes from the throat through the Eustachian tubes into the middle ear. This complication is one of the most frequent causes of permanent deafness.

Nothing need be said concerning isolation, disinfection, or other treatments, as the attending physician will give necessary instruction in these matters.

The early symptoms of measles are usually similar to those which herald the approach of a severe cold,—chilliness, sneezing, catarrh of the nose and throat, redness of the eyes, and cough.

About the fourth day, when the fever has reached its height, the rash appears, continuing two or three days. The most important stage of the disease is convalescence, as it is during this time that the serious lung complications so often make their appearance—bronchitis, broncho-pneumonia, or even tuberculosis of the lungs. It is the frequency of these pulmonary complications that renders measles one of the most serious of children's diseases.

Then in caring for a case of measles, from the very onset of the disease some special treatments should be given to fortify the lungs against these dangerous complications. Perhaps the most efficient measures would be the hot fomentation applied to the chest several times each day. The hot application should be followed by a cold chest compress wrung dry, and thoroughly covered with several thicknesses of dry flannel.