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

e a rupture of the muscles.
Any slight exertion will bring on a spasm, and, later, even a sudden
noise will bring on a convulsion. During a severe paroxysm the chest is
contracted, the diaphragm is restricted, and the respiration is greatly
impaired. The spasms are attended with acute lancinating or
excruciating pains, and though the patient's mind remains clear and he
is conscious of his intense suffering, the viselike contractions render him
unable to cry out.
A copious perspiration bathes the body; inability to eat or drink, coupled
with the severe attacks, produces extreme exhaustion. The spasmodic
contraction of the sphincters causes constipation and retention of the
urine. The temperature may remain normal throughout, or, owing to
disturbance of the heat centers, it may rise to 103°, 104°, 105°, or as
high as 108° or no°.
Chronic Tetanus.—In this form, there is a longer period embraced in the
forming stage. The same symptoms observed in the acute will in time be
enacted in the chronic, with the exception that a paroyxism is followed
by an interval of varying duration when there is relaxation of the
muscles and freedom from pain, save a soreness of the muscles. During
this interval the patient is enabled to take nourishment and stimulants,
thus preventing the exhaustion seen in the acute attacks.
Where recovery takes place, which occurs far more frequently than in
the acute form, the spasms occur at longer intervals and in lighter form,
till they cease entirely. Relapses may occur, however, when least
expected, and the case terminate fatally.
Diagnosis.—The history, showing injury in most cases, the period of
incubation lasting four or more days, the locked jaws and stiffness of the
neck, the muscular contractions spreading downwards, the hands and
arms escaping, the continued rigidity during the intervals of the
spasms, are symptoms so pronounced that the diagnosis is not difficult.
Strychnin poisoning, the disease most likely to produce confusion, is
followed almost immediately upon its ingestion by muscular contraction;
there is usually gastric disturbance, and during the absence of a spasm
there is relaxation. The course of the latter is also much shorter, death
or recovery occurring within twenty-four or forty-eight hours.
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 251