From this general outline, I shall now pass to the treatment adapted to the different forms of scarlatina.
56. TREATMENT OF SCARLATINA SIMPLEX, OR SIMPLE SCARLET-FEVER.
Scarlatina simplex, or simple scarlet-fever (9), without inflammation of the throat, is generally so mild in its course, that it requires little or no treatment. However, I would not have parents look upon it as "scarcely a disease," as neglect and exposure may bring on bad consequences (7 and 25). If the fever and heat are very moderate, the first days an ablution of the body with cool water (say 70°), twice a day, is sufficient. The patient had better be kept in bed, or, if unwilling to stay there, he should be warmly dressed and move about his room, the temperature of which, in this case, should not be below 70° Fahrenheit, and the windows should be shut, as long as the patient is out of bed.
When the period of efflorescence, or standing out of the rash, is over, packs ought to be given, to extract the poison completely from the system, and to prevent any sequels, such as anasarca, &c. (25). Should the rash suddenly disappear before the fifth or sixth day, or should it linger in coming out, a long pack will bring it out and remove all danger. The packs, once begun, should be continued, once a day, during and a few days after desquamation. The patient may go out on the tenth or twelfth day warmly dressed, after his pack and bath, and walk for half an hour; sitting down or standing still to talk in the open air is not to be permitted. During, and some time after convalescence, the patient should take a cool bath, or a cold ablution every morning, immediately on rising from bed, and walk after it as soon as he is dressed. In very cold and disagreeable weather, the walk should be taken in the house; but the patient should not sit down, or stand about, before circulation and warmth are completely restored in every part of the body, especially in the feet. I cannot insist too much upon exercise being taken immediately after every bath, as, without it, the bath may do more harm than good, and dressing, with many, will take so much time, that they will take cold before getting their clothes on.
If the patient should take cold, or feel otherwise unwell, during convalescence, the packs must be resorted to again, and continued till he is quite well.
57. TREATMENT OF SCARLATINA ANGINOSA, OR SORE-THROAT SCARLET-FEVER.
In scarlatina anginosa, or sore-throat scarlet-fever, which is the most common form of the disease (1-7) we have to discriminate, whether
1) the reaction is mild, the heat of the body not being much above 100° Fahr. and the pulse full, but not above 110 to 120, the pain and swelling of the throat moderate, the brain little or not affected; or