SCARLET FEVER. 231 



anxious, and the animal immoveable. Notwithstanding the 

 constant employment of warm fomentations, the swollen 

 parts were hot and painful on being pressed, and pitted con- 

 siderably on the application of pressure. On its withdrawal, 

 the indentations remained for some time. 



"My patient being much debilitated, having eaten but 

 little for fifteen days, I was doubtful, under the circumstances, 

 whether it would be prudent to adopt active depletive 

 measures; but remembering the passage in Dr George Bur- 

 row's well-written article on scarlatina, in the ' Library of 

 Medicine,' wherein he says : ' It might be expected that 

 these dropsical effusions, which are so often the symptoms 

 of constitutional weakness, and which follow a disease char- 

 acterised by great depression of strength, would require a 

 stimulating plan of treatment to remove them; but experi- 

 ence, and examinations of fatal cases, have proved that these 

 dropsies ought to be treated by antiphlogistic remedies:" 

 I determined to follow the principle there laid down. Ac- 

 tive aperients and diuretic medicines were given internally; 

 6 oz. of blood taken from, the jugular vein; hot fomenta- 

 tions applied to the enlargements for twenty-four hours 

 successively; after which, hand rubbing and gentle exercise 

 were ordered. 



" As soon as the bowels began to act freely, a decided im- 

 provement for the better was visible. Three days after, 

 depletive measures were resorted to, the pulse became ex- 

 ceedingly weak and imperceptible at the jaw; the serous 

 effusions, however, had almost disappeared, and the appetite 

 was improving. Tonics and stimulants were now admin- 

 istered, and in ten days my patient was convalescent, and 

 able to take an hour's walking exercise daily." 



Whether it be right to call such cases scarlatina, cannot 

 well be determined. Professor Hertwig of Berlin looks upon 



