Scarlet Fever or Scarlatina. This is an acute febrile disease, producing a scarlet rash upon the skin, attended by a sore throat, and often swelling of various glands, and sometimes followed by dropsy. It is. more com- mon in childhood than in adult life, and one attack confers great, if not complete, immunity from another. This disease gives rise to a great deal of mortality, and chiefly in those under ten years of age. Contagion is the main, if not only cause of scarlet fever; measles and whooping cough are more contagious; typhoid fever and diphtheria less conta- gious. The poison may be retain in clothes for a year or more and then give rise to fever. Both sexes are equally liable to an attack; between eighteen months and five years is the most common time to have the fever; no season has much influence upon it, but in this country it is perhaps most common between November and February. Many people confuse the terms scarlet fever and scarlatina, and imagine the latter is a milder affection; this is a geat mistake, for scarlatina is only the Latin name for scarlet fever, and not Diseases of Infancy and Childhood 337 a different form. Scarlet fever may be very mild, or malig- nant, or latent. The period of incubation is generally about a week, but may be only twenty-four hours. The onset is sudden ; there is sore throat with tenderness at the angles of the lower jaw, and stiffness at the back of the neck; vomiting is very common, and chiefly so in children ; shivering and rigors come on and occasionally con- vulsions in young children. The temperature rapidly rises and will go up to 104'' or 105°; the pulse is very quick, the tongue is covered with a thin, white fur; there is thirst and loss of appetite. This stage lasts from twelve to thirty hours, and then a rash comes out. Sometimes the earlier symptoms are so slight that the rash is the first thing noticed. The rash consists of small scarlet dots, almost running together so as to give a flush all over the skin ; the color disap- pears on pressure, but rapidly re-appears when the pressure is removed. It generally appears at first on the sides of the neck and upper part of the chest and in the bends of the joints; it then spreads downward and is found to come out last on the legs; it begins to fade on the fourth or fifth day and is generally quite gone within a week. Diarrhoea may be profuse, and exhaust the patient. Bleeding from the nose may occur, but is not often a bad symptom. Perforation of the bowel may occur from an error in diet, and is very fatal. Inflammation of the peritoneum adds greatly to the danger. Bronchitis and pneumonia may supervene and increase the danger. Treatment. — Place the patient in a well-ventilated room. Remove all curtains, carpets and bed-hangings. Prevent exertion on the part of the patient. The greatest cleanliness must be observed, and all excreta removed at once, Pond's extract, carbolic acid, or chloride of lime being mixed with them. The diarrhoea need not be checked unless the motions are very frequent, and then a little starch injection maybe given. The diet must be very light, and no solid 338 Diseases of Infancy and Childhood

AI-modernized reading of the original text

Scarlet Fever or Scarlatina. This is an acute febrile disease, producing a scarlet rash upon the skin, attended by a sore throat, and often swelling of various glands, and sometimes followed by dropsy. It is. more common in childhood than in adult life, and one attack confers great, if not complete, immunity from another. This disease gives rise to a great deal of mortality, and chiefly in those under ten years of age. Contagion is the main, if not only cause of scarlet fever; measles and whooping cough are more contagious; typhoid fever and diphtheria less contagious. The poison may be retain in clothes for a year or more and then give rise to fever. Both sexes are equally liable to an attack; between eighteen months and five years is the most common time to have the fever; no season has much influence upon it, but in this country it is perhaps most common between November and February. Many people confuse the terms scarlet fever and scarlatina, and imagine the latter is a milder affection; this is a great mistake, for scarlatina is only the Latin name for scarlet fever, and not Diseases of Infancy and Childhood 337 a different form. Scarlet fever may be very mild, or malignant, or latent. The period of incubation is generally about a week, but may be only twenty-four hours. The onset is sudden ; there is sore throat with tenderness at the angles of the lower jaw, and stiffness at the back of the neck; vomiting is very common, and chiefly so in children ; shivering and rigors come on and occasionally convulsions in young children. The temperature rapidly rises and will go up to 104'' or 105°; the pulse is very quick, the tongue is covered with a thin, white fur; there is thirst and loss of appetite. This stage lasts from twelve to thirty hours, and then a rash comes out. Sometimes the earlier symptoms are so slight that the rash is the first thing noticed. The rash consists of small scarlet dots, almost running together so as to give a flush all over the skin ; the color disappears on pressure, but rapidly re-appears when the pressure is removed. It generally appears at first on the sides of the neck and upper part of the chest and in the bends of the joints; it then spreads downward and is found to come out last on the legs; it begins to fade on the fourth or fifth day and is generally quite gone within a week. Diarrhoea may be profuse, and exhaust the patient. Bleeding from the nose may occur, but is not often a bad symptom. Perforation of the bowel may occur from an error in diet, and is very fatal. Inflammation of the peritoneum adds greatly to the danger. Bronchitis and pneumonia may supervene and increase the danger. Treatment. — Place the patient in a well-ventilated room. Remove all curtains, carpets and bed-hangings. Prevent exertion on the part of the patient. The greatest cleanliness must be observed, and all excreta removed at once, Pond's extract, carbolic acid, or chloride of lime being mixed with them. The diarrhoea need not be checked unless the motions are very frequent, and then a little starch injection maybe given. The diet must be very light, and no solid 338 Diseases of Infancy and Childhood

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