15. SCARLATINA SINE EXANTHEMATE.
There are also mild cases of scarlet-fever, when little or no rash appears, and the throat is very little affected. These are the result of a particularly mild character of the epidemy, together with a peculiar condition of the skin, the desquamation of which shows that the poison went to the surface without producing the usual state of inflammation, or the rash peculiar to the disease. This form, called scarlatina sine exanthemate, is extremely rare.
16. THE MALIGNANT FORMS OF SCARLET-FEVER
are caused by the character of the epidemy, but, perhaps, more frequently by the weak and sickly constitution of the patient and the external circumstances affecting it. Thus, persons of scrofulous habit, being naturally of a low organization, without much power of resistance, are much more liable to experience the destructive effects of scarlatina than those whose organism possesses sufficient energy to resist the action of the morbid poison, and to expel it before it can do any serious harm inside the body.
17. SUDDEN INVASION OF THE NERVOUS CENTRES.
Of the different forms of scarlatina maligna the most dangerous is the sudden invasion of the nervous system, particularly the brain, the cerebellum and the spine, by which the patient's life is sometimes extinguished in a few hours. In other cases the symptoms deepen more gradually, and death ensues on the third, fifth or seventh day.