Plagues and People
Infectious and Epidemic Disease in History
SPRING QUARTER, 2005
Department of History
University of California, Irvine
Instructor: Dr. Barbara J. Becker
Week 6. Contagion?
On Scarlet Fever
from Observationes Medicae circa Morborum acutorum historiam et curationem (1676)
by Thomas Sydenham (1624-1689)
Scarlet Fever (Scarlatina) may appear at any season. Nevertheless, it oftenest breaks out
towards the end of summer, when it attacks whole families at once, and more especially the
infant part of them. The patients feel rigors and shiverings, just as they do in other fevers.
The symptoms, however, are moderate. Afterwards, however, the whole skin become,
covered with small red maculae, thicker than those of measles, as well as broader, redder,
and less uniform. These last for two or three days, and then disappear. The cuticle peels
off; and branny scales, remain, lying upon the surface like meal. They appear and
disappear two or three times.
2. As the disease is, in my mind, neither more nor less than a moderate effervescence of the
blood, arising from the heat of the preceding summer, or from some other exciting cause, I
leave the blood as much as possible to its own despumation, and to the elimination of the
peccant materials through the pores of the skin. With this view, I am chary [cautious
concerning] both of bloodletting and of clysters. By such remedies, I hold that a revulsion
is created, that the particles inimical to the blood become more intimately mixed therewith,
and, finally, that the proper movement of Nature is checked. On the other hand, I am
cautious in the use of cordials. By them, the blood may be over-agitated, and so unfitted
for the regular and equable separation in which it is engrossed. Besides which, they may
act as fuel to fever.
I hold it, then, sufficient for the patient to abstain wholly from animal food and from
fermented liquors; to keep always indoors, and not to keep always in his bed. When the
desquamation [peeling off of scaly skin] is complete, and when the symptoms are
departing, I consider it proper to purge the patient with some mild laxative, accommodated
to his age and strength. By treatment thus simple and natural, this ailment--we can hardly
call it more--is dispelled without either trouble or danger: whereas, if, on the other hand,
we overtreat the patient by confining him to his bed, or by throwing in cordials, and other
superfluous and over-learned medicines, the disease is aggravated, and the sick man dies of
his doctor.
3. This, however, must be borne in mind. If there occur at the beginning of the eruption
either epileptic fits, or coma--as they often do occur with children or young patients--a
large blister must be placed at the back of the neck, and a paregoric [soothing] draught of
syrup of poppies must be administered at once. This last must be repeated every night until
he recover. The ordinary drink must be warm milk with three parts water, and animal food
must be abstained from.
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