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

Gastro-Intestinal Disturbance.—The stomach early feels the force of the
toxin, which is seen in the furred tongue. There is frequent nausea and
sometimes vomiting, especially in the advanced stages and after a
paroxysm of coughing. Often the tongue, which is narrow, elongated,
reddened at tip and edges, speaks of an irritable stomach, which is
attended by some pain and tenderness in the epigastric region. Small
ulcers in the mouth are frequent, and are annoying to the patient.
Diarrhea.—While diarrhea may occur early in the disease, it is usually
found in the advanced stages, and is one of the serious complications,
adding greatly to the prostration. These unfortunates often have
painful hemorrhoids or fistulas, which later increase the suffering and
still further lower the vitality of the already reduced system.
Nervous System.— “Hope springs eternal in the human breast,” is
certainly true in this class of patients, and they are ever planning for
the time when they shall regain their health, are easily encouraged
with any favorable symptom, while changes for the worse are regarded
as only temporary. Derangements of the nervous system are quite rare.
Complications.—An acute pneumonia is not an infrequent complication,
while a diseased pleura is nearly always found at some stage of the
disease. One of the most distressing complications is the involvement of
the larynx. The husky voice or persistent attempt to clear the throat
announces its presence. As the disease extends, aphonia becomes more
complete, and the patient swallows with difficulty. Finally when
ulceration extends to the epiglottis and walls of the pharynx,
swallowing is no longer possible, food and fluids return through the
nose, and the patient literally starves to death.
Physical Signs.—Inspection.—The eye reveals, to the skilled
physician, definite and important conditions, characteristics that either
tell of phthisis or of one susceptible, to the disease.
The chest is long, narrow, and flat, with increased width of the
intercostal spaces. The scapula stand out prominently like wrings, while
the epigastric angle is usually acute. Where cavity formation has taken
place, there is flatness, the most frequent place being over the left apex.
We are to remember, however, that part of this is due to atrophy of the
chest muscles. This chest is known as the “paralytic” or “phthisical
chest.” The respiration is diminished in all stages, but particularly over
the apex.
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 201