. The diseases of infancy and childhood. ort upon 185 cases showing the dis- 966 THE SPECIFIC INFECTIOUS DISEASES astrous consequences of scarlatinal otitis: In 30 there was entiredestruction of the membrana tympani; in 59 the perforation comprisedtwo-thirds or more of the membrane; in 15 there was total loss of hear-ing on one side, and in 6 of the cases upon both sides; in 77 of the casesthe hearing distance for low voice was less than twenty inches. As a cause of permanent deafness and deaf-mutism, no disease ofchildhood compares in importance with scarlet fever. May has collectedstatistics
. The diseases of infancy and childhood. ort upon 185 cases showing the dis- 966 THE SPECIFIC INFECTIOUS DISEASES astrous consequences of scarlatinal otitis: In 30 there was entiredestruction of the membrana tympani; in 59 the perforation comprisedtwo-thirds or more of the membrane; in 15 there was total loss of hear-ing on one side, and in 6 of the cases upon both sides; in 77 of the casesthe hearing distance for low voice was less than twenty inches. As a cause of permanent deafness and deaf-mutism, no disease ofchildhood compares in importance with scarlet fever. May has collectedstatistics of 5,(513 deaf-mutes, of whom 532 owed their condition tootitis following scarlet fever. Kidneys.—Albuminuria accompanies nearly all the severe cases ofscarlet fever. In many this is simply the ordinary febrile albuminuriadue to acute degeneration of the kidneys. In those with severe throatcomplications, and in nearly all the septic cases, there is an acute diffusenephritis; the interstitial changes may be very marked and the kidneys. Fig. Fever of Moderate Severity Followed by Fatal symptoms typical and uncomplicated; twenty-first day vomiting; twenty-fifthday uremic convulsions; death twenty-sixth day. No dropsy; urine never below10 ounces in twenty-four hours; girl ten years old. contain minute abscesses. This occurs at the height of the febrileprocess and is rarely accompanied by dropsy; but albumin, casts, andeven blood may be found in the urine. The most severe and the mostcharacteristic renal complication, and that generally designated aspostscarlatinal nepltriiis, is a diffuse nephritis, with changes in theglomeruli as the most striking feature. It usually develops during thethird or fourth week of the disease, and may follow mild as well assevere cases (Fig. 157). The onset may be gradual, with dropsy andurinary changes, usually accompanied by a slight rise of temperature;or it may be abrupt, without dropsy hut with convulsions, suppres
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