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

disease.
“Synochal and Synochoid Types.—Sometimes, owing to a more intense
character of the exciting cause or to greater depression of the system,
the fever assumes a still more grave form, and is known as synochal or
synochoid, according to the length and gravity of the fever.
“'In synochal fever there are but few premonitory symptoms, the onset
being more or less sudden. The patient's attention is often first arrested
by chilly sensations passing over the body, and a sense of dullness and
languor. Sometimes the chill is well marked, in rare cases amounting to
a rigor, but often the sensation of cold is but slight.
“This chilliness is rapidly followed by reaction; the skin becomes injected,
dry, hot, and burning; the countenance flushed and animated; the
pulse frequent, full, strong, and bounding, rarely hard and oppressed;
respiration is frequent, the respired air hot, and the mouth and nostrils
dry; the bowels are constipated, and the urine scanty and high-colored;
the tongue white, its papillae elongated and erect. The patient
experiences great thirst, and manifests increased sensibility, especially
in regard to light and noise. There is frequently some headache, with
sometimes vertigo, and the patient is watchful, restless, and uneasy. In
children it may commence with a convulsion.
“As the disease progresses, these symptoms increase in severity; the
secretions are still further arrested, the heat and dryness of. the skin
increase, and the patient is more watchful and uneasy. All the
symptoms are usually more exasperated in the evening and early part
of the night. The fever continues to increase in intensity until about the
fifth or sixth day, when there is a tendency to a crisis, and the disease is
frequently arrested by the establishment of secretion. If it progress
much beyond this period, we observe a manifest prostration, the
symptoms being those of synochoid ; and in the course of as many days
more, marked evidence of disorganization of the blood and typhoid
symptoms. We rarely, if ever, see the disease terminate fatally as a
synochal fever, unless complicated with inflammation of some important
organ.
The temperature in synochal fever has a pretty high range. Yet the
wave-lines or difference between morning and evening temperature are
well marked. The following table gives the variations of temperature in
a fever terminating the fifteenth day:
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 255