Beside the ulceration of glands and deafness, some of the sequels of scarlatina are white swelling of one or more of the joints, usually the knee, chronic inflammation of the eyes and eyelids, and partial paralysis. These chiefly occur in scrofulous subjects. Dropsy, which I have mentioned before, is one of the sequels that frequently prove fatal.
26. THE CONTAGION OF SCARLATINA VERY ACTIVE.
The contagion of scarlatina is very active, and adheres for a long time to the sick-room, bedding, clothes and furniture. The best means to destroy it, is plenty of air. It is difficult to say when the contagion is over, as much depends on the season of the year and the care with which the house is aired. Physicians and visitors at the sick-room are very apt to carry it about, unless they be exceedingly careful in changing their clothes and washing themselves, hair and all, before entering other rooms inhabited by persons who had not had the disorder before. It is astonishing how easily such persons are taken by it; and it even sometimes happens that such as have gone through it, take it again in after years. I am authorized by experience, that the idea as if patients under water-treatment, or even such as take a cold bath every morning, were inaccessible to the contagion, is erroneous. I have had patients under treatment for chronic diseases, who had had scarlatina several years before, and neither this nor the water-cure protected them from taking it again. With some of them, however, the throat only became affected and no desquamation took place, whilst the character of the complaint with the rest was rather mild. I have been astonished to read that in a meeting of a medical society of this country, which took place a very short time ago, some members could have raised the question whether scarlatina was really contagious. I admit that the profession in general has not made great progress in the cure of the complaint, but it does not require great study and long experience to know that scarlet-fever is contagious!
27. The form of the disorder in one patient does not imply the necessity of another who caught it from him having it in the same form. A person can take the contagion from one who dies of malignant scarlet-fever and have it in the mildest form, and vice versa. The character of the disease depends very much on the constitution, as I have said above. However, if the epidemy in general is of a malignant character (which may again depend, partly at least, on the constitution of the atmosphere), it will prove so in many individuals who are taken with it, and the precautions ought to be so much the more careful on that account.
28. DIAGNOSIS.
After what has been said about the symptoms of scarlatina, it cannot be difficult to distinguish it from similar eruptive diseases. However, as there is much resemblance between scarlatina and measles, at least in the milder form of the former, I shall give a few symptoms of each, to assist parents in making the distinction.
29. DIAGNOSIS FROM MEASLES.