This disease was not considered dangerous until after the invention of a prophylactic serum, whereupon it immediately became one of the worst scourges of childhood.
The child becomes "suddenly" sick. In most cases there is vomiting and, in children, often a convulsion. The temperature runs up on the first day to 104 or 105. The face is flushed, the skin hot and dry, the tongue heavily coated and the throat is sore. On the second day, often on the first, the rash develops. This appears as tiny red dots on a flushed surface, giving the skin a vivid scarlet color. Beginning on the neck and chest, it spreads rapidly, covering the whole trunk in twenty-four hours. It is not really a "breaking out," but is an intense congestion (erythema, or blushing) of the skin. The skin is swollen and tense and often there is intense itching. The redness disappears upon pressure and disappears after death, as the blood leaves the skin.
One standard medical author tells us that "after the use of belladonna, quinine, potassium iodide, or diphtheria antitoxin, there is sometimes a rash closely resembling that of scarlet fever. In septicaemia (blood poisoning) there may be a similar rash." The rash is a means of eliminating the drugs, serums (proteins) and septic matter. A condition so like scarlet fever that authorities can't agree whether it is or not, frequently follows surgical operations.
The tongue, though coated, is very red on its edges. The taste-buds are swollen, producing the "strawberry" or "raspberry" tongue. In severe cases the throat, always sore, is covered with a membrane which greatly resembles that of severe diphtheria. Other symptoms are those common to all fevers.
The rash begins to fade in two or three days and is completely: gone in four days to a week. I have never had a case to last over four days. The skin peels off.
COMPLICATIONS: Nothing condemns the prevailing medical methods like the frequency with which complications occur in this disease. Acute nephritis develops in 10% to 20% of their cases and is regarded as the starting point for many cases of Bright's disease in later life. Arthritis, acute inflammation of the lining and investing membranes of the heart (endocarditis and pericarditis,) otitis media, often resulting in deafness, and other troubles develop so often as a direct result of the suppressive methods employed that is is a crime to permit them to continue. I have never had a complication to develop in a single case I have treated.
Dr. Arnold H. Kegel, Health Commissioner of Chicago, stated last December, in one of his daily radio speeches to the citizens of Chicago: "The Chicago Board of Health has received numerous letters from parents asking whether it would be advisable to have their children immunized against scarlet fever with serum."
"We cannot assume the responsibility of advising parents to use this serum as it is not in as good standing as it was a year ago. We have been forced to take this stand because of the many unhappy experiences which have resulted from the use of this serum."
Every serum goes through the experimental stage, during which "many unhappy experiences" result from its use. This does not prevent the Health Boards from advising parents to submit their children to these things and to advocate a new one every time an old one is discarded. Toxin-antitoxin has produced more "unhappy experiences" than any other serum ever used, for the reason that it has been more widely used. It is not in good standing in England. It has been abolished by law in Austria, the land of its birth, because of the "many unhappy experiences" which followed its use. In this country it is still being industriously and clamourously exploited.
The true prevention of disease has nothing to do with vaccines, serums, antitoxins, drugs, operations, and the like. True prevention involves adequate food, pure air, an abundance of sunshine, proper exercise, sufficient rest and sleep, cleanliness, mental poise, safety at work, and the absence of all devitalizing habits and ruinous excesses. There is such a thing as being "scientifically ignorant through an excess of science." One may know too much that isn't so.
From 1858 to 1923 the mortality in scarlet fever in New York City was reduced, without the aid of serums, vaccines, antitoxins or toxin-antitoxins, from 155 per 100,000 population to 2 per 100,000. The rate in the city was given in 1927 at 1 per 100,000 population. The Public Health Reports (U. S. Public Health Service), gives the mortality, in 45 states and the District of Columbia, for 1923, as 3 per 100,000. How easy it will be a few years hence, if this decline continues, to "prove over and over again," that the Dick test and scarlet fever serum "wiped out" scarlet fever.
CARE OF THE PATIENT: Properly handled these cases will be free of all rash in four days to a week. There will be no fever after the third day and the illness will be so slight the: parents and friends will say the child was not very sick. And, indeed, he will not be very sick. It requires feeding and drugging to produce serious illness.
These cases should be cared for just as advised for measles and small-pox. Flannel gowns, employed by medical men, in scarlet fever, are not to be employed. These thing belong to the doctoring habit and are of no earthly value.