Hydriatic treatment of Scarlet Fever in its Different Forms Part 7

[26] Kolbany, Beobacht. uber den Nutzen des lauen und kalten Wa.s.sers im Scharlachf. Pressburg, 1808.

[27] Reuss, d. Wesen der Exantheme. Nurnberg, 1818. Vol. III.

[28] A. Edler von Frohlichsthal, Abhandl. uber d. kraftige, sichere und schnelle Wirkung der Uebergiessungen &c. im Faul-, Nerven-, Gallen-, Brenn- und Scharlachfieber. Wien, 1842.

[29] L. Hesse, in Rust's Magaz. Vol. XXVII. 1.

[30] R. Steimmig, Erfahr. und Betracht. uber d. Scharlachfieber und seine Behandl. Karler., 1828.

[31] P. ex. Reich, who kept the sick-room quite cold, and made his scarlet-patients walk out in any weather; he a.s.sures us that he cured his patients in five days, an interesting fact, for the correctness of which, however, the Doctor alone is responsible.

[32] A visit at my establishment of a gentleman, a short time ago, whom I treated for scarlatina anginosa in the city of New-York in February, 1851, reminds me of the sensation caused among his friends by our walking out together on the tenth day in a snow-storm, to take dinner at a restaurant's, where we consumed a partridge and sundry other articles, after which we took a further walk of half an hour. Some physicians of my acquaintance told me "I was killing the man," to which I replied, I would let them know, when he was dead. However, he never experienced the slightest inconvenience from his early exposure; on the contrary, he felt bright and strong on coming home, and has been in pretty good health ever since. He saved, last year, the life of a nephew, who had been given up, by packing him, in scarlet-fever, whilst two of the patient's sisters were allowed to die soon after--unpacked!--Their uncle had been compelled to leave the place of their residence, and the parents had neither courage nor confidence in the water-cure to repeat the process, though their son--whom I saw a few weeks afterwards in vigorous health,--had been saved by it. They had more confidence in drugs which had done nothing for him.

[33] Mr. Rossteuscher, who became afterwards proprietor of a water-cure-establishment near Ca.s.sel.

[34] "And something may be done by way of gargles, to correct the state of the throat, and to prevent the distressing and perilous consequences, which would otherwise be likely to flow from it. A weak solution of the chloride of soda may be employed for this purpose; and if the disease occur in a child that is not able to gargle, this solution may be injected into the nostrils and against the fauces, by means of a syringe or elastic bottle. The effect of this application is sometimes most encouraging. A quant.i.ty of offensive sloughy matter is brought away; the acid discharge is rendered harmless; the running from the nose and diarrhoea cease, &c."

"From several distinct and highly respectable sources, _chlorine_ itself has been strongly pressed upon my notice, as a most valuable remedy in the severest forms of scarlet-fever." Watson, Principles and Practice of Physic.

Dr. Watson also recommends a _drink_, prepared of a drachm of _chlorate of pota.s.s_ to a pint of water, and has found great improvement from the use of a pint to a pint and a half of this solution daily.

Brown gives his scarlet-patients the pure _liquor calcii chloridi_, or the _aqua oxymuriatica_ in quant.i.ties of one teaspoonful every two or three hours and considers this remedy as almost a specific. A solution of the same remedy may be used as a gargle, and also as a wash; and if used internally, I would rather recommend it in preference to the pure liquor, in the hands of persons not used to medical practice. In putrid cases, also the packing sheet may be dipped in a thin solution of chloride.--From an aversion to drugs--very natural in a hydriatic physician--I have never tried medicated sheets, getting along very nicely without them, but I think they must have sufficient virtue to recommend themselves to physicians and parents, who would like to try them.

[35] Captain Claridge, who communicated the above case to the English, and by reprint also to the American public, erroneously reported it a case of _measles_. How he could have made the mistake, I do not know, as the word "Scharlachfieber" in German does not resemble "measles" at all, the latter being called "Masern" in my mother-tongue; but the thought that many a case, which had a bad issue, might have been treated, these twenty-one years, after my method, and many a life might have been saved, but for the mistake of C. C., has often distressed me.

[36] Nothing is more dangerous to the interest of an establishment, where many people are promiscuously collected, than a case of contagious disease, such as small-pox, scarlatina, measles, typhus, &c. I remember a hydriatic establishment in Pennsylvania being broken up entirely, and the physician deprived for a time of the means of subsistence, by his honest and well-founded confidence in the hydriatic treatment of small-pox, and by the generous steps he took in taking a friendless patient, afflicted with that dreaded disease, to his own house, to cure him. He antic.i.p.ated the pleasure it would procure him to show how quickly and how safely he would dispose of the case, and exulted in being able to communicate the fact to his patients. Alas, he little knew, how feeble their confidence in the water-cure was as yet, and how much more they thought of their own safety, than of the water-cure, their physician and the life and health of a poor dest.i.tute fellow-creature. They all left him--part of them came to Florence--and long before he had cured his small-pox patient, he had not one of his old patients left to witness the cure! However impolitic it may appear, I cannot but express my admiration of Dr. S.'s n.o.ble conduct on the occasion, who proved himself not only an honest adherer to our excellent mode of treatment, but also a kind and generous man, worthy of more encouragement than he received at the time.

With that event before me and with a number of some thirty-five or forty patients in the house, I, of course, tried to make them as easy as I could, and confiding in the power of my treatment, sent my own two children, _Paul_, about eight and a half, and _Eliza_, about four years old, to play with the little scarlet-patient, to show how little I was afraid of the disease. In doing so, I, at the same time, satisfied my own heart, by insuring the possibility of treating my darlings myself for scarlatina, which I might not be able to do, were I to let the opportunity escape. Both were taken by the disease, and finding their reaction rather torpid, and the whole process of the disease not without danger, I was glad--when all was over--that I had been able to treat them myself.

I am happy to declare, that none of _my_ patients were frightened away, and that all those who were attacked by the contagion, came off in a very short time and without the least bad consequences. The only exception, in the case of a person who was not a patient, and who came under my hands, after other remedies had been tried on him, I shall communicate hereafter.

PART III.

113. TREATMENT OF OTHER ERUPTIVE FEVERS.

The treatment as prescribed for scarlatina in this pamphlet, is applicable also for other eruptive fevers, such as small-pox, varioloids, chicken-pocks, measles, miliaria, urticaria, zoster, rubeola, erysipelas, erythema, &c., its princ.i.p.al feature being the wet-sheet pack, which may always be safely employed, even by an inexperienced hand. It is not the object of this treatise to discuss all these different diseases in full: I shall do so in a larger work on the water-cure, which I intend to publish in English as soon as I find leisure enough to finish it. But I shall give, in the meanwhile, a few hints sufficient to guide the reader in their treatment.

114. SMALL-POX.

_Small-pox_, by far the most dangerous of them, has found a barrier in its destructive progress in Dr. Jenner's discovery. Vaccination is an almost sure prophylactic against it; but, notwithstanding, many, with whom the preservative was neglected or with whom it proved powerless, have fallen victims to its ravages. There is no remedy in the drug-stores to diminish the danger to which the life, health and appearance of those afflicted with this terrible disease are exposed.

The only safe remedy is the wet-sheet pack.

The water for the sheet should be between sixty-five and seventy degrees, and the bath after the pack, from 70 to 75. Colder water is only applicable before the appearance of the eruption, which may be favored by frictions with bare hands dipped in it. These frictions may be repeated twice a day for the first two days. On the third day a long pack will call forth the eruption. If the patient can be kept in it, he may stay from three to five hours; adults even longer. No harm can be done by it, as the patient produces comparatively little heat, and the longer the pack the surer it will be to bring out the pocks. A short pack will have little effect.

As soon as the pocks appear, rubbing must be avoided till the scabs are entirely gone. The patient should be packed two, three, and even four times a day, according to the condition of the skin and the height of the fever. There is nothing able to relieve the patient as much as the dampness of the wet pack. During the period of eruption and efflorescence, the patient should spend the greater part of his time in the wet-sheet, which not only relieves the general symptoms, but especially the inflammation of the skin, and makes the poison less virulent, by constantly absorbing part of it, and by communicating part of its moisture to the small ulcers.

To protect the face, a kind of mask may be made of several thicknesses of linen, covering the whole of it, leaving openings only for the mouth, nostrils and eyes. The latter may be covered separately. This compress should be covered with one or two thicknesses of flannel, to keep its temperature as even as possible, for which purpose it should be changed as often as it becomes uncomfortably warm.

To draw the poison away from the face and eyes, it will be a good plan to put a thick wet compress on the back of the neck and between the shoulders, and cover it thickly, so as to create a great deal of heat in that region. It will bring out the pocks densely. It should be changed only when it becomes dry.

The stomach should be covered also with a wet compress, as that organ is almost always in a bad state during the whole course of the disorder. If pus is received into the blood, the thick matter which is filtered through the kidneys frequently causes retention of urine. In that case the wet bandage should go around the body, and the patient should drink a good deal of water to attenuate the blood and the urine, and favor the discharge. In case of need, a sitz-bath of 75--or with weak patients of a higher temperature, 80 to 90--will remove the difficulty.

During convalescence, the baths should be made gradually colder, to invigorate the skin and the rest of the organism, and prepare the patient for going out, which may safely be permitted on the tenth or twelfth day. The packs ought to be continued for a week at least after the drying and falling off of the scabs.

By following this treatment, the patient will be safe from any bad consequences of the disease. I have never seen any of the usual sequelae after packs.

115. VARIOLOIDS AND CHICKEN-POCKS.

_Varioloids_ and _Chicken-pocks_, are treated in the same manner, but require less treatment. If well attended to, neither _small-pox_, nor _varioloids_ or _chicken-pocks_, will leave any marks.

116. MEASLES.

_Measles_, which may be easily distinguished from scarlatina, by the symptoms I have given under 29, are to be treated like the mildest forms of scarlet-fever, and, in most cases, require no treatment at all.

Nervous affections are treated like those of scarlet-fever (92, &c.).--As measles are more dangerous to adults than to children, whose skin is much more active, they had better take packs, without waiting for an increase of the symptoms.

117. URTICARIA, ZOSTER, RUBEOLA.

_Urticaria_, _Zoster_ and _Rubeola_, are treated in the same manner as measles: the main feature, however, is the pack.

118. ERYSIPELAS.

_Erysipelas_ being commonly the reflexion of an internal disease with a peculiar tendency towards the skin, should not be treated locally alone, but with due regard for the original disease. If possible, the patient should perspire freely in long packs, whilst a wet compress relieves the local inflammation. The compress, without the pack, would be apt to cause a metastasis to a vital organ. Sometimes a derivative compress, as mentioned under small-pox (114), will draw the inflammation away from a very painful and dangerous spot. It is advisable to try it, if the seat of the inflammation is the face or head. The water for the sheet, compress and bath should not be lower than 65. I know several cases of rapid cures of erysipelas, by throwing a profusion of cold water on the parts affected. But, although I do not remember any harm done by such a process, I can scarcely recommend it, as long as there are milder and safer remedies at our disposal.[37]

119. ERYTHEMA.

_Erythema_ may be considered an exceedingly mild form of erysipelas, and yields to gentle treatment, as it is given in measles.

120. ADDITIONAL RULES FOR THE TREATMENT OF ERUPTIVE DISEASES.

In all these eruptive diseases, especially small-pox, all I have said, in speaking of scarlatina, about ventilation, air, diet, &c., ought to be duly observed. In small-pox, a constant renovation of the air is indispensable, as the morbid exhalations from the body of the patient are most offensive, and the contagious poison most virulent.

121. The temperature of the room, however, should be a few degrees higher than in scarlatina, as none of these other eruptive diseases shows the same degree of fever and heat. This is particularly advisable in the treatment of measles, when exposure is very apt to cause the rash to disappear, an occurrence which is dangerous in any eruptive disease.

122. CONCLUSIVE REMARKS.--OBSTACLES.

Before concluding my article, I shall attempt to remove a few objections and obstacles, which are usually raised against the practice of the hydriatic system in families.