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

From two weeks to three months is the usual period, though it may be
prolonged to one year or more. The wound frequently heals as readily
from the bite of a rabid dog as from one not affected.
Prodromal symptoms are headache, loss of appetite, and a depression
that is somewhat characteristic, the patient being melancholy, with the
sense of impending danger. There may be a stinging sensation or
itching at the seat of the bite, and the part becomes numb; sometimes
the cicatrix becomes red and swollen. These symptoms last from one to
three days.
The patient is restless and uneasy, and the slightest noise, a flash of
light, a draft of air, or a sudden call, will produce undue excitement; or
the patient sits quietly in a despondent mood, with an occasional sigh.
As the disease progresses towards the spasmodic or true hydrophobic
stage, respiration becomes oppressive and the voice rough, and a seizure
may be expected momentarily; this stage lasts from one to three days.
The second stage is characterized by spasmodic contraction of the larynx
on attempts at swallowing. The sight of water produces great fear, and
often precipitates a spasm which is attended with great suffering; the
dyspnea is great, and the convulsive action of the larynx and muscles of
the mouth causes the patient to emit guttural sounds, which, to the
excited and horror-stricken observer, seem to resemble the bark or howl
of a dog. The temperature is usually slightly elevated, from 100° to
103°, though the temperature may be subnormal.
These paroxysms occur at intervals; when the seizure subsides, the
mind is perfectly clear, though the patient is greatly exhausted. In
extreme cases, the patient is maniacal, and must be prevented from
injuring himself or attendant. This stage lasts from one to three days,
and gradually passes into the third stage, known as the paralytic stage.
The paroxysms become less violent, the patient being able to swallow
with some difficulty, the prostration is great, the heart's action feeble,
the skin is relaxed, and the surface is covered with a cold sweat. The
mind, which has been clear during the interval of intense suffering,
now becomes clouded, and the patient finally passes into coma, the
spasms entirely subside, and in from ten to twenty hours the patient
expires.
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 247