The Therapeutic Value of the Quartz Mercury Vapour Lamp in the Treatment of Acute Scarlet Fever and Serum Unticaria

Roughead, John A (1936) The Therapeutic Value of the Quartz Mercury Vapour Lamp in the Treatment of Acute Scarlet Fever and Serum Unticaria. MD thesis, University of Glasgow.

Abstract

A study of a series of unselected cases of scarlet fever has been carried out with the object of demonstrating in this disease the effect of exposure to ultra-violet light upon the course, specific characteristics, and complications. For this purpose observations upon one hundred and eighty seven cases are set out and the relevant positive findings are controlled by parallel series each of similar numbers of cases, (a) which received no specific treatment, and (b) which were treated by antiscarlatinal serum. With the further aim of investigating the effect of irradiation upon the incidence and nature of serum urticaria one hundred cases showing this allergic manifestation were treated by ultra-violet light; the facts emerging from this procedure are controlled by comparison with a further group of one hundred cases not so treated. In the production of urticaria the relative potency of antidiphtheritic and antiscarlatinal sera has been observed in one hundred cases of diphtheria and in one hundred cases of scarlet fever, all of which received in treatment approximately equal volumes of the appropriate antiserum. The possibility of modifying, by preliminary irradiation, the allergic potentiality of serum has been probed in one hundred and ten cases receiving serum thus prepared. The observed facts as set out in the foregoing pages would appear to justify the following conclusions 1. Irradiations from a quartz mercury vapour lamp are entirely without effect on the duration of the rash of scarlet fever. It is to be noted, however, that, when viewed under the lamp, the characteristics of the rash are accentuated and that in this medium they remain visible for an appreciably longer time than when viewed in ordinary white light, and the mercury vapour lamp has thus a definite value as an aid to the diagnosis of doubtful rashes. 2. Despite the fact that the fall of temperature of acute scarlet fever cases is uninfluenced by exposure to ultra-violet light, it is desirable that the initial temperature of the patient be allowed to become normal before exposure to the lamp. (vide infra 5). 3. Although the general well being of the patient is improved the actual duration of the disease is unaffected by exposure to ultra-violet light. 4. Ultra-violet light has little or no effect on the normal course of scarlatinal desquamation. 5. Exposure of scarlet fever patients to ultraviolet irradiations diminishes the tendency to develop septic sores, otorrhoea and rhinitis. The incidence of nephritis is unaltered provided, as in (2), irradiation is commenced after the initial temperature has settled. Other common complications are unaffected. Although it is unwise to draw conclusions from the happy outcome of isolated cases, the rapid cure of a single Instance of erythema nodosum, a condition notoriously refractory to treatment, amply justifies the massive doses utilised and offers a useful suggestion for a routine procedure in this condition. 6. Following the use of antiscarlatinal serum the liability to urticaria is greater than in the case of antidiphtheritic serum, while the developed rash is more irritable and of longer duration. 7. Cutaneous allergy to antis carlatinal serum occurs usually on or about the eighth day, has an average duration of 52.4 hours, is accompanied by itching in 42%, of cases, and by joint pains in 10%. 8. In the treatment of serum urticaria ultraviolet irradiation with the quartz mercury vapour lamp is of undoubted value - itching is promptly relieved, and the duration of the urticaria diminished by an average period of 30.1 hours. The local and systemic effects of the rays are seen to best advantage when dosage is pushed to the production of a second degree erythema only. 9. Preliminary irradiation of the serum produces no difference in the incidence of urticaria, delays its appearance for approximately one day, shortens its duration by 4.6 hours, modifies markedly its irritability and diminishes any associated rise in temperature by 13.9%. Preliminary irradiation of the serum is apparently not inimical to its antitoxic properties and therapeutic value.

• Item Type: Thesis (MD)
• Qualification Level: Doctoral
• Keywords: Medicine
• Date of Award: 1936
• Depositing User: Enlighten Team
• Unique ID: glathesis:1936-80073
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 03 Mar 2020 09:45
• Last Modified: 03 Mar 2020 09:45
• URI: https://theses.gla.ac.uk/id/eprint/80073