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

This period comes on so insidiously that the prodromal symptoms are ill
defined, and the first evidence of the disease is the catarrhal stage.
The child appears to have taken cold. There is some irritation of the
Schneiderian membrane, with increased secretion from the same, and
also increased secretion of tears, with more or less hoarseness. The
cough, even in the early stage, is suggestive, coming on in paroxysms,
though at this time the characteristic whoop is absent. The patient at
this period is considered by the mother to have taken cold, and the
favorite cough mixture is prescribed; this facing, the physician is
consulted, who many times makes the same mistake, only to be
discovered when the whoop develops.
The patient now begins the cough with a full inspiration, and continues
it till the air is entirely expelled from the lung and the child is
completely exhausted. The paroxysm is made up of a series of sharp,
hard, exasperating, and explosive coughs, and during its continuance
the patient presents to the anxious mother an alarming and frightful
appearance.
As the cough progresses, the child becomes red in the face, the color
soon changing to a livid or purplish hue; as the violence increases, the
eves seem as though bursting from their position, the lips become
swollen, the veins of the neck become distended, and sometimes blood
bursts from the nose, mouth, and even the eyes or ears. A glairy,
tenacious mucus is expelled as the result of the severe coughing, and
frequently vomiting ensues, especially if a paroxysm of coughing comes
on soon after taking nourishment.
During this time there is a spasmodic closure of the glottis, and when
the paroxysm is over, the child gasps for breath, and the air, rushing
through the contracted larynx, gives rise to the whoop. If the paroxysm
has been very severe, the child is limp and exhausted for some
moments; at other times he resumes the play, interrupted by the fit of
coughing, as though the attack was of no importance.
There may be only three or four attacks in twenty-four hours, or they
may occur as often as every thirty or sixty minutes.
If the chest be examined during an attack, we will find dullness during
expiration, and resonance full and clear during inspiration. The
respiratory murmur is, however, indistinct or absent, owing to the small
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 148