Advice to a Mother on the Management of Her Children

by Pye Henry Chavasse

216. What is the difference between Scarlatina and Scarlet Fever?

They are indeed one and the same disease, scarlatina being the Latin for scarlet fever. But, in a popular sense, when the disease is mild, it is usually called scarlatina. The latter term does not sound so formidable to the ears either of patients or of parents.

217. Will you describe the symptoms of Scarlet Fever?

The patient is generally chilly, languid, drowsy, feverish, and poorly for two days before the eruption appears. At the end of the second day, the characteristic, bright scarlet efflorescence, somewhat similar to the colour of a boiled lobster, usually first shows itself. The scarlet appearance is not confined to the skin; but the tongue, the throat, and the whites of the eyes put on the same appearance; with this only difference, that on the tongue and on the throat the scarlet is much darker; and, as Dr Elliotson accurately describes it,—"the tongue looks as if it had been slightly sprinkled with Cayenne pepper;" the tongue, at other times, looks like a strawberry; when it does, it is called "the strawberry tongue." The eruption usually declines on the fifth, and is generally indistinct on the sixth day; on the seventh it has completely faded away. There is usually, after the first few days, great itching on the surface of the body. The skin, at the end of the week, begins to peel and to dust off, making it look as though meal had been sprinkled upon it.

There are three forms of scarlet fever;—the one where the throat is little, if at all, affected, and this is a mild form of the disease; the second, which is generally, especially at night, attended with delirium, where the throat is much affected, being often greatly inflamed and ulcerated; and the third (which is, except in certain unhealthy districts, comparatively rare, and which is VERY dangerous), the malignant form.

218. Would it be well to give a little cooling, opening physic as soon as a child begins to sicken for Scarlet Fever?

On no account whatever. Aperient medicines are, in my opinion, highly improper and dangerous both before and during the period of the eruption. It is my firm conviction, that the administration of opening medicine, at such times, is one of the principal causes of scarlet fever being so frequently fatal. This is, of course, more applicable to the poor, and to those who are unable to procure a skilful medical man.

219. What constitutes the principal danger in Scarlet Fever?

The affection of the throat, the administration of opening medicine during the first ten days, and a peculiar disease of the kidneys ending in anasarca (dropsy), on which account, the medical man ought, when practicable, to be sent for at the onset, that no time may be lost in applying proper remedies.

When Scarlet Fever is complicated—as it sometimes is—with diphtheria, the diphtheric membrane is very apt to travel into the wind-pipe, and thus to cause diphtheric croup, it is almost sure, when such is the case, to end in death. When a child dies from such a complication, the death might truly be said to be owing to the diphtheric croup, and not to the Scarlet Fever, for if the diphtheric croup had not occurred, the child would, in all probability, have been saved. The deaths from diphtheria are generally from diphtheric croup, if there be no croup, there is, as a rule, frequent recovery.