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

pulse-beat is from 120 to 140 per minute; the skin becomes hot, dry, and
constricted; the temperature rises to 103°, i04°, or even 107°. The
tongue is heavily coated, and sordes early show on the teeth and lips in
the form of dark, bloody crusts. The vomiting may continue through this
stage. The patient may become very restless, with active delirium, or the
delirium may be passive, early passing into stupor. The pulse now
becomes small and feeble, the face assumes a bluish hue, with coldness
of the extremities, and collapse is threatened; enlargement of the glands
now begins, and the third stage is present.
Development of Buboes.—The lymphatics in the groin first appear,
followed, in severe cases, by those of the axilla and other parts of the
body; these develop from the third to the fifth day. If suppuration
occurs, it is looked upon as a favorable symptom.
Carbuncles often occur in connection with the buboes, a favorite
location being the legs, buttocks, and back of the neck. Petechiae also
may appear, which is always regarded as a grave symptom. These are
known as plague spots,—responsible no doubt for the term “Black
Death,” the body becoming livid or black after death.
Convalescence, or Fourth Stage.—This stage begins from the sixth to the
tenth day, and may be rapid, or prolonged for days, by the suppuration
of the buboes.
Pneumonic Form.—In this variety the infectious agent enters by way of
the lungs, while in other cases it is usually by bites or abrasions of the
surface. In this form the lungs receive the full force of the poison, which
is shown by the cough, bloody expectoration, pain in chest, and all the
phenomena of pneumonia. These cases number the greatest fatality,
and often death intervenes before the development of the buboes.
Septicemic Form.—This is regarded by Sternberg and others as rather a
secondary phenomenon, occurring in fatal cases, and not a distinct form
of disease.
Diagnosis.—The diagnosis would not be difficult during an epidemic;
the sudden invasion, high fever, and the development of buboes are
symptoms so characteristic as to leave but little room for doubt.
Prognosis.—This is the most fatal of all the infectious diseases,
ranging from eighty to a hundred per cent.
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 232