Scarlet Fever: An Assessment of the Clinical Value of Alkaline Treatment

Rankine, James Eric (1938) Scarlet Fever: An Assessment of the Clinical Value of Alkaline Treatment. PhD thesis, University of Glasgow.

Abstract

(1) An examination of evidence showed that a return of a more severe form of scarlet fever is to be expected in this country, and that this will probably be accompanied by a rise in the incidence of scarlatinal nephritis. (2) Several methods of prophylaxis against scarlatinal nephritis have been suggested. The one which has attracted most attention is the administration of large doses of alkalies. (3) Several workers have tried this method, but their conclusions show little agreement. (4) I set out to test the clinical value of the method in a strictly controlled series of cases, in order to define the true place of alkalies in the treatment of scarlet fever. (5) Two series of cases were studied:- (a) Test Series - 618 cases. Patients in this series received sufficient alkalies to keep the early morning urine at a pH. of near 8.3 for the first 28 days of the disease. (b) Control Series - 618 cases. These cases received no alkalies. In all other respects they received similar treatment to the cases in the test series. When serum (antiscarlatinal or diphtheria antitoxin, was considered advisable it was given to patients in either series. Care was taken to assure the greatest possible similarity between the series. (6) In the test series there occurred 6 cases of albuminuria and 9 eases of nephritis. In the control series there were 16 eases of albuminuria and 12 cases of nephritis. Albuminuria was, on the average, milder among the alkali-treated eases, while the same percentages of cases of nephritis fell into the various grades of severity in each series. Owing to the benign nature of albuminuria its lowered incidence in the test series is unimportant, and the reduction of nephritis from 12 to 9 cases is insufficient to prove benefit from alkalies. (7) Other interesting points relating to the complications of scarlet fever were brought out in the course of the investigation - viz. (a) that complications are commoner in younger than in older children, and (b) septic complications are most numerous at the ages of 3 and 4 years. (8) A reliable method of preventing renal complications in scarlet fever has yet to be found.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Keywords: Medicine
• Date of Award: 1938
• Depositing User: Enlighten Team
• Unique ID: glathesis:1938-80143
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 03 Mar 2020 07:47
• Last Modified: 03 Mar 2020 07:47
• URI: https://theses.gla.ac.uk/id/eprint/80143