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

Exciting Cause.—To Kitasato belongs the honor of discovering the
specific cause, the bacillus pestis bubonicæ. This is a short bacterium,
almost as broad as long. On entering the body, either by inoculation or
by way of the digestive or respiratory tracts, it multiplies with great
rapidity. It is found in the blood, in the internal organs, in the intestinal
canal, lymphatic glands, and in great numbers in suppurating buboes.
Outside the body it is found in dust and infected clothing and bedding
of infected houses; it is also found in fleas, flies, rats, mice, cats, dogs,
and other domestic animals. It is now believed that rats are the common
carriers of this dread plague.
Pathology.—Rigor mortis occurs early, and often there is elevation of
temperature immediately after death. Petechiæ, ecchymoses, and
carbuncles are generally found upon the skin. The lymphatic system is
early affected, the lymph glands of the groin and axilla being the first to
show evidence of the inflammation.
Broncho-pneumonia is a common result, the lung tissues being involved
more than in ordinary broncho-pneumonia. The spleen is soft and
swollen, with hemorrhagic areas. The liver and kidneys also show
degenerative changes.
Symptoms.—Three varieties are recognized: (1) The bubonic; (2) The
pneumonic; (3) The septicemic. The first named is the most frequent and
typical.
Four stages are given: (1) Invasion or prodromes; (2) Fever; (3)
Localization, or development of the buboes; (4) Convalescence.
Incubation.—This period lasts from twelve hours to seven or eight days.
Invasion.—This stage begins suddenly, with dizziness, pain in the head
and back, and with more or less depression; the patient is dull, eyes
expressionless, and the mind is confused. When the patient attempts to
walk, he staggers like a drunken man. There may be no distinct rigor,
but chilliness occurs, with nausea and vomiting. Often diarrhea appears
early. These symptoms last twelve, twenty-four, or thirty-six hours,
when the second stage is ushered in.
Fever.—This stage frequently commences with a chill, followed by a
quick rise of temperature. The pain in the head and back increases; the
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 231