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

amount of air passing through the contracted glottis. During the
intervals of the paroxysms, various sounds are heard, depending upon
the complication. This stage continues from two to four weeks, when the
stage of decline follows. There is nothing peculiar to this stage, simply a
gradual subsidence of the preceding symptoms.
The paroxysms are increased by exciting the emotions, fits of crying
almost invariably bringing on an attack. The inhalation of any irritant
will also prove an excitant.
Complications.—The complications are numerous, and give, to an
otherwise harmless disease, a degree of danger. A common, though not
dangerous, complication is hemorrhage, which may be from the nose or
the lung.
Vomiting may be frequent, and at times so severe as to give rise to
gastric derangement, resulting in anemia or general marasmus.
Ulceration of the frenum linguae is quite common.
The more serious complications, however, are those of the respiratory
and circulatory apparatus. As a result of a severe paroxysm of coughing,
there may be a rupture of the pulmonary alveoli, giving rise to
interstitial emphysema. Broncho-pneumonia, so often attended by
collapse, is one of the most serious and fatal results. Enlargement of the
bronchial glands often occurs, and, when the patient is delicate or
bottle-fed, may lead to tuberculosis. As a result of the great strain upon
the heart, valvular troubles are not uncommon. Convulsions are not
frequent, though occasionally seen.
Diagnosis.—The diagnosis is readily made after the characteristic
whoop develops; before this we may not be positive, although the
catarrhal symptoms, hoarseness and spasmodic cough, are suggestive of
the trouble.
Prognosis.—Although this affection has been regarded as one of the
fatal diseases, Dolan ranking it third in fatality in children's diseases in
England, I have never been able to understand the large mortality
attributed to it, and an experience of nearly twenty-five years bears me
out in saying that the prognosis should nearly always be favorable.
In very young, bottle-fed, delicate babies, with pulmonary
complications, the prognosis should be guarded, otherwise it is
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 149