[Infectious diseases 169]

Sore Throat.—­This we find on the pillars of the fauces, uvula, tonsils, and pharynx, reddened and inflamed.  Sometimes it is very severe, and a membrane comes on one or both tonsils and pillars of the fauces.  There is, generally a severe sore throat, and this makes swallowing difficult.

Tongue.—­The tongue is covered with a coating at the onset, and may present a slightly reddened appearance at the borders and tip.  The papillae are prominent and covered and look like a strawberry sometimes, or like the tongue of a cat.  In fatal poisonous cases it becomes dry and cracked.

Scaling.—­As the disease subsides the outer layer of the skin dries and peels off.  The extent of this depends upon the severity of the attack.  In some cases the scaling is hardly perceptible, and sometimes it appears only on certain parts, such as on the toes and inner parts of the thighs.  There is always some scaling.  This is called “desquamation.”  Generally speaking, scaling begins where the eruption first appeared on the upper part of the chest and neck.  The scales may be fine and branny or as is most common, the skin peels in large particles.  Some scaling is always present.  The length of the scaling time is variable.  It usually lasts from three to four weeks, but often longer.  This stage is considered by many as the most contagious, as the fine scales fly in the air.

Complications.  Nose.—­The nose is affected at the same time if the “sore throat” is very severe.  A membrane may also form in the nose.

Ear.—­This may be affected in as high as one-fifth of the cases and needs careful watching and attention.  Both ears may be diseased and deafness frequently results from it.  Ten per cent of those who suffer from “deaf-mutism” can trace their affliction to scarlet fever.  The ears usually become afflicted in the third week.  The fever rises and there is pain in the ears or ear.  The onset may not appear alarming and not be suspected until the discharge makes its appearance This is unfortunate; these complications are serious, as meningitis and abscess of the brain may result.  The ear trouble (otitis) usually occurs during the scaling.  The patient may be up and around.  There is a rise of the temperature to 103 or 104 degrees, the patient begins to vomit food and has a headache.  At night the child starts from its crib and cries as if in pain.  They do not always locate the pain in the ear.  The face and hands may twitch.  The fever may fall to normal and rise sharply again.  Such symptoms should call for a thorough examination.

Eye.—­Inflammation of the (conjunctiva) red membrane of the eyes, often occurs.

[170 Mothers’ remedies]