After convalescence, the room and everything which has been exposed should be thoroughly disinfected, and feather or straw beds, or other things which cannot be thoroughly disinfected, should be burned. Formaldehyde is probably the best, safest, and cheapest disinfectant in use. N. D. Coxe (Sani tarian, Aug., '97).
Experiments to obtain an antitoxin for the diplococcus scarlatina?. Using swine as the largest animals susceptible, a blood-serum was obtained which pro tected guinea-pigs from cultures of the same germ, the control animals dying in six or seven days. W. J. Class (Phila. Med. Jour., June 23, 1900).
Treatment.—Many specifics for scarlet fever have been proposed, tried, and found wanting. Much may be done to avert complications and to render them less serious when they occur, and many lives may be saved by judicious manage ment. Mild cases require little or no medication; they usually receive too much.
The patient should be kept in bed for at least three weeks, and should receive a fluid diet for not less than two weeks. Milk is the best diet for scarlet-fever patients. It may be given peptonized or plain. Later in the disease broth, eggs, or meat-jellies may be given. The stom ach should never be overfilled.
The initial vomiting usually requires no treatment, but the bowels should be acted upon mildly by small, repeated doses of calomel. Later they should be kept acting, if possible, by means of enemata rather than by the use of ca thartic drugs.
For Foetid diarrhcea in the initial stage of scarlatina:— 13 Sulphate of magnesia, 30 grains. Dilute sulphuric acid, 30 minims. Simple syrup, 4 drachms.
Distilled water, 3 ounces.
M. Sig.: A teaspoonful to a table spoonful every hour according to age. Editorial (Med. News, Jan. 15, '93).
In severe cases stimulants are required. In malignant cases they should be pushed to the point of tolerance. Strychnine is of great value in septic eases with pros tration; it may often be combined to advantage with digitalis. Bathing the surface with warm water followed by anointing with plain or carbolic vaselin or a 5-per-cent.-ichthyol ointment should be begun as soon as the first signs of desquamation appear and should be con tinued throughout the course of the dis ease.
The throat symptoms of the first few days may be mitigated by giving cool water or bits of ice. Later hot drinks
may be given or irrigation of the back of the throat with a weak hot saline or boric-acid solution may be employed. Chlorate of potash should be avoided.
Its beneficial effects are doubtful and its known irritating effect upon the kidneys contra-indicate its use. Nasal syringing should be avoided unless clearly indicated by a purulent nasal discharge or tion of the naso-pharynx. More harm than good may result from overzealous attempts at local treatment of the throat and nose. The most successful treat ment consists in the use, not of active and poisonous antiseptics, but of mild and cleansing washes, freely and fre quently applied.
Adenitis can only be controlled by checking the septic process at its ain-head in the throat. The application of hot oil or the hot-water bag is sooth ing to some patients, but the use of cold is preferable in most cases. Poultices should not be applied continuously. Dif fuse suppuration requires free incision.
Otitis requires the treatment demanded by the disease in other conditions. The joint affections require bait little treat ment other than rest and protection. Rheumatism should receive its own ap propriate treatment. Restlessness and nervous symptoms are sometimes relieved by cold to the head or by the use of small doses of phenacetin, not enough being given to materially affect the ture. Nephritis should receive prompt and very careful attention. Its treatment is that of nephritis due to other causes. Only those diuretics should be used in nephritis of scarlet fever which do not irritate the kidney. Acetate of sium is one of the safer diuretics in this complication. In severe cases, with eral oedema and threatening urcemia, thartics are rather more certain in their action than diaphoreties and diuretics. and are especially indicated where, as i= usually the case, constipation is present. Podophyllin in doses of grain may be given to a child five years old, and be repeated a number of times. It usually acts quickly. The compound jalap pow der, in doses of from 5 to 10 grains, may also be given where a rapid and decided derivation by the intestine is indicated.