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

one person there is but little sensitiveness of the respiratory apparatus,
though the lesion is severe, while in another, although the lesion is but
slight, there is extreme sensitiveness. The cough is usually more
pronounced in the mornings and evenings, and after partaking of food
and drink, in the latter case often resulting in vomiting.
Pain.—Pain is the unpleasant symptom of any disease, and, if
persistent, adds to the gravity of the case. While it may be absent from
beginning to end, it is generally present at some stage of the disease. It
may be a sharp pain in the apex, or a stitch in the side, especially on
taking a full inspiration. If pleurisy be present, the pain is lancinating
or stabbing in character. Again, a common- location of the pain is under
the shoulder-blade or between the shoulders.
Expectoration.—The sputum varies as to quantity, quality, color,
consistency, and odor, depending upon the rapidity with which the
destructive process takes place, and also the form, whether or not there
be mixed infection. At first it is white and frothy, or glairy, tenacious,
and streaked with blood. This soon changes to an opaque and yellowish
color, soon followed by a mucopurulent material. At times there will be
soft, cheesy particles of a grayish color, which aids one materially in the
diagnosis.
Where cavities form, the sputum becomes heavy, lumpy, coin-shaped,
nummular, and of a greenish-yellowish color. There is a slight, sweetish,
sickening odor in some cases, while in others there is but very little.
Where there is mixed infection, there may be marked fetor. In the
earlier stages there may be considerable bronchial mucus mixed with
the expectoration. In children and very old people the expectoration is
very scanty.
In examining the sputum for bacilli, the grayish, cheesy particles should
be taken, as they are rich in germs. To obtain elastic fibers, which is
now regarded as of additional value, boil equal parts of the sputum and
a solution of caustic soda; empty into a conical-shaped glass, and cover
with cold water. The sediment can then be carefully examined for this
product. Where calcification has taken place, there may be spit up with
the mucus, particles of chalky material as large as a pea.
Hemoptysis.—Hemorrhage from the lungs varies verv greatly in
quantity and time. Some patients pass through all phases of the disease
without the suspicion of a hemorrhage. Other patients will show this
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 198