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

disease. The membrane disappears, the throat clears up, and yet our
patient does not convalesce. There is a low, irregular fever, the pulse is
small and feeble, the heart is poisoned by the toxins engendered, and
the patient dies of heart-failure caused by septicemia; or, if recovery
take place, weeks elapse before the patient's health is restored.
What is true of this disease is sometimes observed in pneumonia,
erysipelas, and others of a kindred type. Where the infection is due to
toxins, the symptoms are of a very grave nature, typhoid in character,
the tongue early showing evidence of sepsis. The secretion tells the same
story, while the nervous system confirms the evidence of both. Death is
usually the termination of this form, in from three to seven days.
Diagnosis.—The history of the patient will assist materially in making
our diagnosis. A retained placenta, a puerperal peritonitis, a tubercular
ulcer, and kindred lesions, would shed much light on the case, while
toxins from milk, ice-cream, cheese, canned goods, etc., would be equally
plain, and local injuries could not wen be overlooked.
Its more rapid development and less marked initial chill would enable
one to differentiate it from pyemia. In the latter disease the fever is
more irregular, chills and rigors recurring as in malarial fever. A
jaundiced appearance of the skin is more pronounced in pyemia, and,
while not constant, should have weight in recognizing the disease.
Prognosis.—The prognosis will depend upon the character of the
poison, the amount of infection, the ability of the system to remove the
offending cause, and the skill with which we meet the septic processes
by antagonistic remedies.
If the offending cause can be removed before the system is thoroughly
infected, the case will terminate favorably. Where there is great gastrointestinal
irritation, the circulation rapid but weak, and when delirium
appears early or coma becomes marked, the prognosis will be
unfavorable.
Treatment.—It seems hardly necessary to say that we must get rid of
all sources of putrefaction that are still further poisoning the patient. If
a pus tube be the offending organ, it should be removed or drainage
established. If the uterus contain offending material, it should be
emptied of all debris. Where there is a diseased endometrium, it should
be thoroughly curetted, and, when necessary, this should be followed by
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 173