LONDON LETTER. SCARLATINA IN INDIA.
By a
coincidence the
happy
question
of the
prevalence of Scarlet fever in India and other tropical countries has been simultaneously raised in the Journal own
of Tropical Medicine and in pages. The subject has been from
your time to time discussed in the Indian Medical Gazette since the year 1870. It has been made quite certain that Scarlatina has been reinto India by means of troopthis in that manner small outbreaks ships, and in have arisen military stations and among civil communities, both on hills and plains. It has also been conclusively proved that these epi-
peatedly imported
are very limited both in space and time. has been inferred that India and other
demics It
tropical regards
countries
possess an immunity as disease, that is to say, that the microbe which presumably causes it, belong-
ing
as
this
it
parasites, favouring
seems to
does
do to the class of
j;not
obligatory
tropical conditions for life and propagation.
find in
circumstances Once admitted into the individual, it appears to give rise to the same pathological phenomena countries. It must therefore be as in
temperate
the interval of transit from the diseased to the healthy subject that it encounters an environment inimical to either existence or
during
virulence
or
both.
The
exact
truth
of its
Nov.
LONDON LETTER.
1899.]
somatic and extra-somatic, remains to be worked out, but the facts already ascertained justify these provisional conclusions natural
history,
The curious and really
important fact, which
the papers to which I have referred place in evidence, is that an eruptive, febrile disease, resempresenting close if not complete clinical blance to Scarlatina, arises sometimes in India cle novo, and that occasionally such cases occur in groups and seem to result from communication. I have myself seen such cases singly and in in Calcutta and at Darjeeling, and they
groups have been
the literature on the subject shows. In these instances the question of importation has been held in view ; but the circumstances of their occurrence were, in most cases, such as to render this mode of origin met with
by others, as
true extremely unlikely ; and it seems absolutely that, as in imported cases, so in these autogenous weak, cases the power of infection is exceedingly the incidence very limited, and the duration of the outbreak short. The aspect which has been
displayed
is that of
favouring
condition,
disease which is
a
epidemic
under
of
imcapable but novo incapable
plantation or even origin de of propagation. The matter is therefore of profound interest both pathologically
one
and
hoped that, as and opportunity offers, by general, clinical mooted bacteriological methods, the points above will be eventually cleared up both as regaids India and the tropics generally. epidemiologically,
and it is to be
415
By a
coincidence the
happy
question
of the
prevalence of Scarlet fever in India and other tropical countries has been simultaneously raised in the Journal own
of Tropical Medicine and in pages. The subject has been from
your time to time discussed in the Indian Medical Gazette since the year 1870. It has been made quite certain that Scarlatina has been reinto India by means of troopthis in that manner small outbreaks ships, and in have arisen military stations and among civil communities, both on hills and plains. It has also been conclusively proved that these epi-
peatedly imported
are very limited both in space and time. has been inferred that India and other
demics It
tropical regards
countries
possess an immunity as disease, that is to say, that the microbe which presumably causes it, belong-
ing
as
this
it
parasites, favouring
seems to
does
do to the class of
j;not
obligatory
tropical conditions for life and propagation.
find in
circumstances Once admitted into the individual, it appears to give rise to the same pathological phenomena countries. It must therefore be as in
temperate
the interval of transit from the diseased to the healthy subject that it encounters an environment inimical to either existence or
during
virulence
or
both.
The
exact
truth
of its
Nov.
LONDON LETTER.
1899.]
somatic and extra-somatic, remains to be worked out, but the facts already ascertained justify these provisional conclusions natural
history,
The curious and really
important fact, which
the papers to which I have referred place in evidence, is that an eruptive, febrile disease, resempresenting close if not complete clinical blance to Scarlatina, arises sometimes in India cle novo, and that occasionally such cases occur in groups and seem to result from communication. I have myself seen such cases singly and in in Calcutta and at Darjeeling, and they
groups have been
the literature on the subject shows. In these instances the question of importation has been held in view ; but the circumstances of their occurrence were, in most cases, such as to render this mode of origin met with
by others, as
true extremely unlikely ; and it seems absolutely that, as in imported cases, so in these autogenous weak, cases the power of infection is exceedingly the incidence very limited, and the duration of the outbreak short. The aspect which has been
displayed
is that of
favouring
condition,
disease which is
a
epidemic
under
of
imcapable but novo incapable
plantation or even origin de of propagation. The matter is therefore of profound interest both pathologically
one
and
hoped that, as and opportunity offers, by general, clinical mooted bacteriological methods, the points above will be eventually cleared up both as regaids India and the tropics generally. epidemiologically,
and it is to be
415
