An American text-book of the diseases of childrenIncluding special chapters on essential surgical subjects; orthopaedics, diseases of the eye, ear, nose, and throat; diseases of the skin; and on the diet, hygiene, and general management of children . 248). Symptoms.—The onset of scarlatina is usually so abrupt that its begin-ning may be fixed with considerable definiteness. There is possibly a pre-vious slight duskiness of the skin, chilliness and malaise, but usually thefirst thing that attracts attention is vomiting, often without any relation toa previous meal; or there may be diarrhoea. Ol
An American text-book of the diseases of childrenIncluding special chapters on essential surgical subjects; orthopaedics, diseases of the eye, ear, nose, and throat; diseases of the skin; and on the diet, hygiene, and general management of children . 248). Symptoms.—The onset of scarlatina is usually so abrupt that its begin-ning may be fixed with considerable definiteness. There is possibly a pre-vious slight duskiness of the skin, chilliness and malaise, but usually thefirst thing that attracts attention is vomiting, often without any relation toa previous meal; or there may be diarrhoea. Older children may not actuallyvomit, but complain of nausea, languor, headache, and sore throat, and feelchilly, although the face is flushed, and the thermometer may show a tem-perature as high as 103°-105° F. If such children are also drowsy, theymay become delirious in their sleep. The pulse is full and strong (120—160),the skin is hot and dry. and the throat feels stiff and uncomfortable, and. ifexamined, will show a characteristic punctate redness. Such is the ordinaryonset of a typical case of scarlet fever, but there is no disease of childhoodthat is liable to wider and more eccentric variations in its onset and course, PLATE SCARLET FEVER. SCARLET FEVEB. 137 oscillating between the very slight abortive form and that frightful varietycalled by the French foudroyant, or scarlatina fulminans, fortunately rarelymet with; for in such cases the child succumbs, mortally poisoned from thevery first by the virulence of the scarlatinal virus, without any prodromal stageor hardly any symptoms except those which may be referred to the nervoussystem. These dreadful cases often run their entire course in from thirty-sixto forty-eight hours without eruption or sore throat, the only symptoms beingnausea, dizziness, loss of consciousness, coma, violent delirium, or convulsionsattended with abnormally high temperature (107°). Scarlatina simplex may be differentiated in twenty
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