SCARLET FEVER. Synonyms.—Scarlatina; Scarlet Rash. Definition ...

The primary fever lasts from three to five days, during which time a
rash, varying in character, appears, though not in all cases. It may be
scarlatinal, rubeolar, herpetic, papular, etc., and is usually followed by
desquamation. This primary fever is followed by an intermission of two
or three days, attended by great relief, though there is soreness and stiff
ness of the joints, the patient exhibiting the peculiar gait already
mentioned. In some cases the temperature becomes subnormal, while in
others there is only a remission.
In from two to five days a secondary fever occurs, whereupon all the
symptoms of the primary fever are reenacted, though usually in a less
aggravated form. This secondary fever is of shorter duration, lasting
only two or three days. It is also attended by the same rash as the
primary.
Although the duration of the fever is only from seven to ten days,
convalescence is apt to be slow and quite protracted. The prostration
that follows a severe attack is very marked, the patient being unable to
do severe mental or physical work for weeks.
Diagnosis.—When prevailing as an epidemic, and especially when it is
of a severe type, there is but little difficulty in establishing a diagnosis.
The sudden onset, high temperature, excruciating pain in muscles and
joints, and the appearance of the eruption, leave but little doubt. In
sporadic cases it may be mistaken for inflammatory rheumatism, but a
careful study will soon show the distinguishing features of each.
Another disease likely to be confused with dengue is la grippe. The
onset, the marked myalgia, are similar in each, but there the similarity
ends.
Prognosis.—It is rare for a case to end fatally, only those of advanced
age or persons of feeble vitality succumbing to its influence.
Treatment.—The disease being self-limited, the object of our treatment
will be to reduce the febrile state, allay the intense pain, and render the
patient as comfortable as possible. Rest in bed should be emphasized,
and the diet should be fluid in character; milk and rich broths being
best suited to sustain the patient's strength.
For the high fever, use the wet-sheet pack, assisted by veratrum, if the
pulse be full and strong, and combined with gelsemium where there is
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 228