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

accounts for the symptoms resembling meningitis.
The disease may begin more or less suddenly, with marked cerebral
excitement, or convulsions may usher in a severe form that may prove
fatal in a few days. As a rule, the disease has a course of from two to six
weeks in children, and from three to five months in the adult.
Symptoms.—Prodromal Stage.—This stage may last for some weeks,
especially if following measles or wmooping-cough or the infectious
diseases of childhood. The child is cross and fretful, restless at night, the
appetite capricious, the breath is bad, and the tongue is coated. The
bowels are usually constipated. The child has occasional spells of
vomiting, which can not be traced to wrongs of the stomach. The patient
loses flesh and strength, the face has a pinched appearance, the eyes
are contracted, and the child, if old enough, complains of pain in the
head.
Stage of Cerebral Excitement.—These symptoms growr more pronounced
till the stage of excitement is fully ushered in. Chilly sensations,
accompanied by severe headache and vomiting, may usher in this stage.
The pain in the head is often of an intense character, the child uttering
a sharp, piercing, hydrocephalic cry. The face is flushed, eyes bright,
and pupils contracted. The screams of the child may persist for hours or
until the child is completely exhausted.
Vomiting, so characteristic of cerebral irritation, is a prominent
symptom. The bowels are obstinately constipated. The fever is usually
not very high, the temperature ranging from 101° to 103°, though
sometimes it may reach 104° or 105°. The pulse is small and rapid
during the early days of the fever, but grows irregular as the disease
advances. With the progress of the disease, owing no doubt to the
pressure caused by the exudate, the cerebral symptoms become more
passive. The patient becomes dull and drowsy, the pupils, which at first
are contracted, now dilate, and the child sleeps with the eyes partly
open. There is twitching of the muscles, and retraction of the head,
especially when the spinal meninges are involved. The respiration may
become, irregular and sighing.
Stage of Paralysis.—This stage occurs as the patient nears the end of
the struggle. The patient can not be aroused, lies with the eyes partly
closed, and there is involuntary twitching of tendons and muscles.
Paralysis of the third nerve is most common, which may involve the
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 186