I’m not a medical professional, but I did find this article.
A small cadré of military researchers at the base seized the moment, executing a provocative series of trials that tested the potential of antibiotics to prevent post-streptococcal rheumatic fever. Roughly 2% of the trainees given placebo in their studies developed rheumatic fever, while under 1% of trainees given antibiotics experienced the disease. For every 50-60 trainees treated with antibiotics, the researchers had successfully prevented one case of rheumatic fever. It was a small, but decisive victory.
Prior to the epidemic at Warren Air Force base there was little interest in ‘strep throat’. During the twenties and thirties in the Unites States, sore throat care focused on diphtheria, “the strangling angel.” The characteristic ‘bull neck’ and the dreaded grey pseudomembrane led to a gruesome, asphyxiating death for thousands of children each year. Comparatively, strep throat was a minor nuisance that often received little more attention than the common cold.
I was digging around in census records for 1800’s Britain while researching my family tree. One of my ancestors’ families, they had 3 boys in 3 years, all named Peter. I think this is more a very sad case than a “This is my other brother Larry” moment. Odd thing was, I didn’t see high mortality in the 1700’s, larger families and higher child mortality seems to have picked up in the later 1800’s. I presume crowded cities and poor sewer systems contributed to this.
There’s a scandal and outrage in Canada the last year or so that they are finding unmarked graves of children beside Indian Residential Schools. These boarding schools operated for 100 years or more, and typically several hundred children at a time were forced to attend each school, to force social assimilation - forbidden to talk their native language, forced to observe Christian religions, neglect and abuse, etc. basically horrific.
Unfortunately, the current complaints about these discoveries seem to imply it was deliberate mass murder when in fact, worse, it was deliberate ignoring of a simple fact - cram a few hundred children with less developed immune systems together and all manner of childhood diseases will run rampant. The number of graves suggests a few died each year over 100 years of operation, so the number of deaths would not be abnormal.
(This is not to suggest the government did nothing wrong. It was an expected outcome that the authorities seemed to not take many steps to avoid. On top of abuse and neglect - The whole sequence is wrong - the concept of forced assimilation, forcing children to leave home and attend - basically kidnapping them, conditions that probably did not actively seek to prevent or limit disease, burying the dead with little ceremony or no markers since presumably that was not in the government budget, not bothering to inform parents - often the children’s names were not tracked, and remote native villages had no postal service or addresses. The whole mess reeks of the injustice that happened, but sadly the death of the children was predictably common in those times. )
That’s an interesting read. I would have thought “symptoms of strep throat abate within hours” would be enough of a reason to treat it with antibiotics, honestly.
The medical knowledge of the time was enough that they knew pretty much exactly what was wrong, to the point of culturing the bacteria from a blood sample. But there was no useful treatment, just knowledge that he was going to die, and soon.
George Washington died in 1799 of a throat infection (Google tells me “acute bacterial epiglottitis”) which would be easily cured today. Instead, his death was agonizing, in part because of the severe blood letting and other archaic practices of the time.
Step can get into the blood stream and one place it can do damage is the heart valves.
many heart valve replacement surgeries are done due to strep damage.
so you can survive the fever stage, and die from strep, effectively, some time later
Few people of any rank in society had an easy or comfortable death in that pre-modern medicine age.
The importance of making a ‘good’ death, in the sense of making your confession and receiving absolution from the priest was considered more important in many Christian cultures, as your destination in the next world was what mattered.
I read a couple period books where they painted the back of the throat with antiseptics.
Yeah. And I read too many times about some smart herbal healer in the past doing things like putting moldy bread on the would, or willow bark tea.
Penicillin prefers cantaloupes, not bread, and it is mostly useless topically. Sure, there is some small chance you might get something what would help, but about ten times more likely you will introduce something nasty and deadly.
Willow bark was known since Roman time, but it really tears your stomach up. For mild headaches the cure would be worse than the problem. Now we can treat willow bark so it is no so bad, but the ancients knew about it and didn’t use it much because of the known side effects like vomiting blood.
Homeopathy worked on the placebo theory and what was better- it contained no harmful shit. It was also kinda cheap.
Chiropractic will help a sore neck or back sometimes. It isn’t 100% quackery although the Theory behind it is 100% Bullshit. Like Acupuncture, which can work, but the theory is 100% horseshit.
Scarlet fever is VERY COMMON today and has NO specific association with increased risk of morbidity (such as Rheumatic Fever which includes heart problems; or Post Strep Glomerulonephritis, PSGN, kidney problems from strep throat; and very rarely pneumonia) or death. It is just one way to easily be very confident that this specific sore throat is caused by Group A B hemolytic strep.
ALL Scarlet Fever means is the presence of a characteristic rash that sometimes occurs with strep throat infections, caused by erythrogenic toxins that the germ can produce. It is just a symptom of strep, but it is a very specific one. I diagnose Scarlet Fever with regularity. It is not a scary thing at all.
Historically Group A streptococcal infections had a fairly high incidence of morbidity and mortality. In today’s world untreated strep will usually resolve just fine. Treatment speeds the process up and decreases the period of contagiousness. But as already noted:
Antibiotics reduce the risk of the now in any case rare after illness complications of Group A strep - Rheumatic Fever and PSGN - and the even rarer spread of the germ to other sites, like a pneumonia. They get people better faster and make them less likely to spread it sooner.
In 1850 either we as hosts were different, or the organisms were different, and while most recovered from strep throat in several days just fine, but some significant number developed complications that would not have occurred with antibiotics and would be very rare to happen today without antibiotics as well.
Yes, but in moderation it isn’t enough to really stop a bad headache. But yeah, a small amount, especially if not taken on a empty stomach isn’t so bad.
Not as common as in the past, but yeah, it is not like smallpox or anything.
Yes, but not for anything that they were used to treat in the past. " Clearly, modern clinicians do not support the practice of bloodletting. However, many do believe the use of leeches in certain, very specific medical situations has the potential to save lives and limbs." They are used for localized venous congestion after surgery, not to cure an imbalance of humors. They are useless for treatment of seizures, fevers, etc,
The old Discovery Health Channel had a program called “Leeches, Maggots, and Bees” which aired many times, and was quite interesting.
30 years ago, when I was in college, the hospital pharmacy where I worked got an order one weekend day for medicinal leeches, which were kept in a covered tank. I was the only person who was willing to retrieve them, so I put on shoulder-length gloves, scraped 4 of them off the tank with a small fish net, had the pharmacist verify the order, and we sent it to the floor. Most likely, the person had a small(ish) body part reattached (finger, ear, nose, even penis) and the blood wasn’t circulating properly.
Specially-bred maggots can also be used to debride non-healing wounds. We had a patient at my old hospital who had these ordered, and I wanted to see them when I rounded with the doctors but this was the crew that didn’t allow the pharmacist into the room.
I knew that leeches aren’t being used for the conditions they were commonly used for in years past, but it interested me that they are still being used today.
I wonder if even in 1850 leeches were used in situations where the physician knew (or strongly suspected) they really wouldn’t do any good. Sometimes patient relations situations mean doctors prescribe something they know won’t help, but figure won’t hurt. Times when it’s considered important to do something, even when that something is ineffective.
For modern equivalents, look at the doctors who prescribed ivermectin for treatment or prevention of COVID. Or, more commonly, antibiotics for viral infections.