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

not to be confused with a metastatic parotitis which sometimes follows or
accompanies such infectious fevers as dysentery, diphtheria, and other
low-grade fevers.
Etiology.—The specific cause is a contagion generated during the
course of the disease, but, like that of the eruptive fevers, its exact
nature is not known. Bacteriologists have as yet failed to isolate a
specific microbe which will of itself produce the disease. All that is
necessary for one to contract the disease, is to come in contact with the
breath of the afflicted person, the excretions, especially the salivary
secretions, or even the apartments occupied by the patient.
One attack secures immunity from a subsequent one, though single
mumps will not prevent the opposite gland from suffering subsequently
if exposed to the contagion. While it may be endemic in large cities, it
nearly always prevails an as epidemic, affecting children in preference
to adults, though the latter are not exempt. It prevails more extensively
in the spring and fall months.
Pathology.—Trousseau claims that the lesion does not proceed beyond
an exalted hyperemia and congestion, while Virchow believes that there
is a catarrhal inflammation of the ducts of the glands. Certain it is that
the changes, whatever they may be, are of such a slight character that
suppuration rarely occurs. The gland becomes swollen and hard; but
after a few days it subsides, resolution being complete.
Symptoms.—Occasionally the patient will complain of feeling ill for a
day or two before the development of the disease. The head and back
ache, the appetite is impaired, the bowels are constipated, and there is
an unpleasant taste in the mouth.
The period of incubation is from ten days to three weeks, during which
time there are rarely any symptoms which would indicate the coming
trouble. Usually there is a slight chill, followed by more or less febrile
reaction, and with the development of the fever the swelling of the
parotid gland is first noticed. The child complains of pain just below the
ear, especially when it opens or closes the mouth.
In some cases the chill and fever will be so slightly marked that the
patient does not call attention to it. In others, every symptom will be
marked and severe, and the patient may have a high fever for a week.
The swelling may be confined to one side and run its course without the
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 144