X. Scarlet Fever (Febris Rubra) Scarlatina.
Scarlet Fever is chiefly a disease of childhood, especially from the second to the fifth year of life. It is by no means unfrequent in the second year, and even occurs in the first, although infants a few months old seem to enjoy a special exemption. Of the entire mortality from Scarlet Fever, about sixty-eight per cent, is among children under five years of age, and about twenty-four per cent. more among children from five to ten years. After the tenth year the liability to it rapidly diminishes. The common notion that Scarlatina is mild, and Scarlet Fever a severe, form of the disease is incorrect, for the terms have the same meaning.
VARIETIES. I. S. Simplex. A scarlet rash with moderate fever, redness, but no ulceration of the throat. 2. S. Anginosa. Ulceration of the throat, with tendency to the formation of abscess in the neck; the temperature is high, and the circulatory disturbance great. 3. S. Maligna. The rash comes out imperfectly or irregularly, is hardly visible, or appears and disappears alternately, and is dark-red rather than scarlet; the throat is dark, or even sloughy; the tongue is brown; the nose is excoriated; intense fever, extreme debility, great brain disturbance, and low delirium are present. In this variety there is consequently great danger to life.
Scarlatina is more likely to take on a malignant form than any other eruptive fever, and it sometimes prevail as an epidemic in low, ill-drained, and densely-populated districts. It should always be under the care of a homoeopathic physician, as the mildest forms, neglected, have often led to the worst results.
GENERAL SYMPTOMS. After lying hid in the system for about five days, Scarlatina commences with the ordinary symptoms of fever shivering, hot skin, frontal headache, rapid pulse, nausea, sometimes vomiting, thirst, and sore throat. The last-named symptom is generally the first complained of. After a short time the pulse becomes very quick, often 120 to 140 in the minute. In about forty-eight hours after these symptoms, the rash comes out on the breast, neck, face, body, joints, and limbs, till the whole body is covered with it.
The eruption usually fades away in the same order. Its appearance is a bright scarlet, having the colour of a boiled lobster-shell. The colour disappears on pressure, but immediately returns on its removal.
The tongue at first is coated with a creamy fur, the tip and edges are red, the little dots are red and raised, giving it a straw-berry-like appearance. This is always seen in the course of the disorder, and not unfrequently at its commencement. The tongue afterwards becomes clean and raw-looking. From the fifth day to the ninth the rash disappears, leaving the child more or less prostrate. The outer skin now comes off in scurf, or in large pieces from the hands and feet.
In the malignant form the eruption is either entirely wanting, or dark and partial. Sometimes the lining membranes are threatened with mortification, the glands and even the tissues of the neck are very much swollen, and the fever is attended with prostration so extreme that the patient may sink in a few hours.
EPITOME OF TREATMENT.
Scarlatina Simplex. Belladonna Alt. Aconite; Arsenicum (during scaling of the skin); Sulph, (recovery).
S. Anginosa. Apis (much swelling and hoarseness); Mercurius, Cantharis (ulceration of throat); Veratrum-Vir. (severe brain symptoms, vomiting, and fever).
S. Maligna. Ailanth., Baptisia, Arsenicum, Murex-Ac. Carbolic Acid; also spray of Sulphs.-Ac., Hydrastis, or of Condy’s Fluid, diluted; one part of any to about ten of water.
Belladonna. Is specific, and exerts a direct power over Scarlet Fever in its simple form.
Aconitum. Much feverishness, thirst, dryness, and heat of skin.
Gelsemium. Imperfect eruption, nervous restlessness, remittent symptoms.
Veratrum Viride. Severe brain symptoms, vomiting, and very rapid pulse. It may be given turn-about with Belladonna These two are most frequently useful.
Muriatic Acid. Malignant sore throat, with extreme depression, tremors, etc.
Ailanthus Gland. Malignant Scarlatina, with purple or nearly suppressed rash, foetid discharge from the nostrils, cracking at the corners of the mouth, etc. It should be given directly unfavourable symptoms are observed, and frequently repeated until improvement ensues. This is indicated by increase of the eruption, by its taking on a scarlet colour, and by lessened fever.
Arsenicum. Prostration, excessive thirst, cold clammy sweats, frequent weak pulse, diarrhoea, dropsy.