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

alarming condition early in the disease, but as the case advances it
disappears entirely; while another class of patients will “spit blood” more
or less frequently during the entire progress of the disease.
In the early stages the hemorrhage is rarely ever profuse and never
dangerous, while those occurring in the advanced stage may prove
fatal, though this is very rare. The blood is usually bright red and
frothy, characteristic of hemoptysis. The mucus may be simply streaked
or tinged with blood, or it may be decidedly rusty. Hemorrhage most
frequently occurs after mental excitement, or physical exertion, or
paroxysm of coughing, though sometimes it occurs without any
apparent cause. Thus, in one of my patients, the hemorrhage invariably
occurred in the night, he being awakened by a choking sensation,
which was due to the pressure of the blood.
In the milder forms it follows the cough, while at other times it seems to
flow to the upper part of the larynx and into the pharynx, and is simply
spit out. The hemorrhage is due, in the early stages, to hyperemia, and
the blood exudes from the feeble vessels, most likely, due to pressure
from tubercular deposits. After cavity formation, there may be erosion of
a larger vessel, when the hemorrhage becomes alarming and very
rarely fatal. In a practice of twenty-five years I have met with but one
fatal hemorrhage in this disease; this in a child ten years old, who died
in five minutes after the rupture of the blood-vessel.
Hemorrhage from the lungs, while not necessarily an evidence of
tuberculosis, should always be regarded with grave suspicion, and cause
careful and repeated examinations on the part of the physician.
Dyspnea.—In the early stage of the disease there is little suffering from
“shortness of breath,” unless preceded by active exertion. In the later
stages, however, it often proves one of the most distressing conditions.
General Symptoms.—Fever.—One of the earliest symptoms, even
before the cough, is an elevation of temperature, and if it remains
constant for days, with a progressive decline in health, it is one of the
most reliable evidences of the dread disease. The first evidence of the
toxin in the blood is to produce fever, which varies in character. In one
it will be of the continued type, while in another it will be remittent or
intermittent in character, or again partake of both, being decidedly
irregular. In fact, the irregular character of the fever in tuberculosis is
one of its characteristics.
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 199