PEDIATRICS Vol. 68 No. 2 August 1981, pp. 230
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WILLIAM DOUGLASS ON THE FIRST REPORTED CASES OF SCARLET FEVER IN NEW ENGLAND, 1736

T. E. C. Jr MD

In 1736, William Douglass (1691-1752) of Boston, wrote an excellent account of an epidemic of a "new" disease which he called angina ulcusculosa, yet his description of this "new epidemical eruptive fever" was the first adequate description of scarlet fever in English.1 Douglass's account was published twelve years before John Fothergill (1712-1780),2 the English physician, published his classic account of both diphtheria and scarlet fever, although Fothergill failed to differentiate between the two conditions.

Douglass wrote:

The first attack is somewhat of a chill or shivering; soon after follows Head ake or some other versatile spasmodick pains, as pain in the back, joints, side, etc; a vomiting or nausea, or in some constitutions, which are not easily provoked to vomit, only a certain uneasiness or sickness at Stomach; at the same time the Uvula, but chiefly the Tonsils, were tumified, inflamed and painful, with some white specks, then follows a flush in the Face and some miliary eruptions therewith a benign mild fever, the same efflorescence soon after appears on the neck, chest and extremities; the 3rd or 4th Day, Eruption is at the hight and well defined with fair intervals; the flushing goes off gradually with a general itching; and in a Day or two more the cuticle scales or peels off, especially in the extremities: At the same time the cream coloured sloughs or specks in the Fauces become loose and [are] cast off ... The tongue from the beginning is furr'd as in a Mercurial Ptyalism, urine high coloured... in the whole course of the Distemper [there is] a very great prostration of strength and faintness...[and a] loss of en bon point.