Character of scarlet fever compared with that of measles.—­It will be seldom difficult to distinguish this disease from other acute eruptive disorders.  The one to which it bears the greatest resemblance is the measles; but from this it is readily distinguished by the absence of the cough, the inflamed and watery eye, running at the nose and sneezing, which are the predominant symptoms in the early stage of the measles; but which do not usually attend on scarlet fever—­at least, in any high degree.  In measles, also, there is an absence of that restlessness, anxiety, and depression of spirits, by which scarlet fever is peculiarly distinguished.—­The rash, too, in measles, does not appear till two or three days later than that of scarlet fever.  It also differs in its characters.  In scarlet fever, the eruption consists of innumerable minute dots or points, diffused in patches with uneven edges of various sizes and forms; and gives to those portions of the skin on which it appears, a diffused bright red colour.  In measles, the rash comes out in irregular semi-lunar or crescentic shaped patches, distinctly elevated; the spots being of a deeper red in the centre than in the circumference, and leaving intervening spaces in which the skin retains its natural pale colour.

Maternal management.—­The chief points to which the parent’s attention must be directed, irrespective of a strict attention to the more immediate medical treatment directed by the physician, are the following:—­

Ventilation of the bed-room.—­Even in the mildest cases, the child must be kept in bed from the first accession of the fever.  He must not be loaded, however, as was formerly the practice, with a quantity of bed-clothes, in order to encourage the fever and increase the quantity of eruption.  A moderate quantity of clothing is all that is required, adapted to the heat of skin and feelings of the patient.

The bed-room must be kept cool and well ventilated.  This is of importance in the mildest cases; but in the more severe forms of this disease, in which the throat is much affected, the constant and free admission of pure air will have a most decided and marked good effect upon the symptoms.  The air should be renewed, therefore, from time to time.  The linen, both of the bed and the patient, should also be frequently changed daily,—­if practicable.

However mild the symptoms of this disease may be at the commencement, the child must always be carefully and vigilantly watched by the parent, as inflammation of some internal organ may suddenly arise (which is generally indicated by symptoms sufficiently obvious), and thus change an apparently mild form of this disease into one of an alarming character.