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

“With Predominant Affection of the Gastro-Enteric Mucous
Membranes.—In some cases we observe, at the commencement, marked
symptoms of disorder of the stomach; the tongue is heavily coated,
especially at its base, with a dirty-yellowish secretion; there is slight
nausea; disgust for food, and oppression in the epigastrium; everything
that is administered is taken by the patient with difficulty, and
frequently ejected. This condition is not generally accompanied with as
high febrile reaction as in the uncomplicated fever; but there is rapid
prostration, and manifestation of typhoid symptoms. In this case there is
increased secretion of mucus from the mucous membrane of the
stomach, which, if allowed to remain, will undergo decomposition, and,
being slowly absorbed, will generate decomposition of the blood. In other
cases there is marked irritation of the stomach, manifested by redness of
the tip and edges of the tongue, uneasiness in, and pain on pressure
over, the epigastrium, with nausea and rejection of fluids and solids
taken into the stomach. In this case, all the febrile symptoms are
increased.
“The enteric affection does not generally manifest itself in the early
stage of the 'disease. It commences with looseness of the bowels, two,
three, or four evacuations in the twenty-four hours, with pain and
soreness in the abdomen, especially on pressure. The tongue is moist
and loaded with a dirty-white or grayish fur, which, as the fever
advances, changes to brown, and sordes appear on the teeth and lips; in
some cases, the edges and tip of the tongue are reddened. In this case,
the fever rapidly assumes a typhoid character.”
Diagnosis.—The diagnosis of febricula is not difficult if we remember
its chief characteristics; namely, the sudden onset, high temperature,
104° or 105° within twenty-four hours, and great restlessness and
undue complaint, notwithstanding the tongue is comparatively clean
and moist, and the absence of hardness of pulse, although very rapid,
and the early decline of all of the above seemingly grave symptoms,
render the case quite plain.
In synochal fever, the continued reaction determines the type of the
fever; the great excitation of the nervous system, with but little
prostration, and the full, bounding pulse, distinguish it from synochoid
or typhoid.
In synochoid, the history of a slow forming stage, the uniform
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 259