SCARF 



SCARLATINA 



199 



quieter North Cliff The South Cliff and the old 

 town (below the Castle) are separated hv a pictur- 

 esque gulley, which is spanned by the Cliff Bridge 

 (1827 ; 414 feet long, 75 nigh), and, farther up, by 

 the Ramsdale Valley Bridge (1865). Scarborough 

 (A.S. Skardeburge, 'fortified rock') is an old place, 

 for Harold Hardrada ravaged it in 1066, and in 

 1181 it received a renewal of au earlier charter; 

 and it returned two members to parliament from 

 Edward I.'s time till 1885, when the representation 

 was reduced to one. The castle, now a shattered 

 Norman keep, dates from 1136, but was rebuilt as 

 a royal fortress by Henry II. It was captured by 

 the Earl of Pembroke from Pierg Gaveston (1312), 

 by Bruce (1318), by the Earl of Westmorland 

 from the insurgent Lord Stafford (1553), and twice 

 by the parliamentarians (1644-48), besides being 

 unsuccessfully besieged by Aske in the Pilgrimage 

 of Grace ( !">:> i. Near it is St Mary's, the church 

 originally of a Cistercian priory ( 1320). Transition 

 Norman and Early English in style, with later 

 additions, it suffered much during the siege of 1644, 

 and was restored in 1848-50, at a cost of 7000. 

 St Martin's (1862) is a good Early English struc- 

 ture, with windows by Morris. Other buildings 

 are the splendid aquarium (1877), the iini.scum 

 (1828), the market-hall (1853), the huge Grand 

 Hotel ( 1867), and the Spa (1880), the third on the 

 siti-, whose two saline and chalybeate springs were 

 discovered about 1620, and which has charming 

 grounds. Scarborough was made a head port in 

 1840. The tidal harbour, with a lighthouse and a 

 floating-dock, was formed l>etween 1732 and 1850, 

 and is enclosed by three piers, the longest and 

 outermost curving 1380 feet; on the North Sands 

 is a promenade pier 1000 feet long ; and here, too, 

 a promenade, nearly 4000 feet long and 24 wide, 

 constructed in 1887-90 at a cost of 50,000, wag 

 opened by the Duke of Clarence. The jet manu- 

 facture i a specialty. The season lasts from June 

 till tin- middle of October, when visitors |xmr in by 

 thousands from every part of the kingdom. Resi- 

 dent pop. (1851) 12,915; (1881) 30,504; (1891) 

 33,776. 



See work* by Gent (1736), Hin.lerwell (3d ed. 1832), 

 J. Brogden Baker (1882), and Havi land (1883). 



Scarf. S<-i- STOLE. 



Scarlatina, or SCARLET FEVER, is one of the 

 group of diseases called Exanthemata (q.v.). In 

 addition to the characters common to the group, 

 scarlatina is almost always attended by sore throat, 

 and the rash or eruption, which is of bright scarlet 

 colour, commonly appears as early as the second day 

 after the manifestation of the febrile symptoms, 

 and is followed by very distinct desquamation 

 of the cuticle. The period of incubation (see 

 MEASLES) is very rarely more than a week ; some- 

 times as little as twenty-four hours. Most writers 

 on medicine make three varieties of this disease viz. 

 S. rimplex, in which there are the fever and the 

 rash, but only slight throat affection ; S. anginosa, 

 in which, in addition to the fever and the rash, the 

 throat affection is the most prominent symptom ; 

 and ,S'. maligna, a name which is applied to certain 

 cases of extreme virulence, in which the system is at 

 once overwhelmed by the force of the disease, or 

 in which the symptoms disclose an extraordinary 

 decree of weakness and want of vital power. 



The disease begins with shivering, lassitude, head- 

 ache, a frequent pulse, a hot dry skin, a flushed 

 face, thirst, loss of appetite, and a furred tongue. 

 Shortly after the appearance of the febrile symp- 

 toms the throat begins to feel irritable, and, on 

 examination, is found to lie red, and often more or 

 less swollen. This redness lieeomes diffused over 

 the interior of the month and the tongue. The 

 fash on the skin begins in the form of minute red 



points, which soon become so numerous that the 

 surface appears almost of a uniform red. It first 

 appears on the neck and breast, whence it gradu- 

 ally spreads over the trunk and extremities. The 

 reddened surface is smooth to the touch, and the 

 colour temporarily disappears on pressure of the 

 finger. The eruption, in ordinary cases, is persist- 

 ent for three or four days, after which it gradually 

 disappears, and is usually gone by the end of the 

 seventh day. The cuticle then begins to scale off 

 iti small bran-like scurf, or in flakes of various sizes. 

 Specimens of an almost entire epidermic covering 

 of the hand or foot, forming a natural glove or 

 slippsr, are of common occurrence in our patho- 

 logical museum." ; but it is comparatively seldom 

 that such perfect moulting takes place. The de- 

 squamative process is hardly ever completed till at 

 least five weeks from the commencement of the 

 cli-i-iise, and may last considerably longer. The 

 fever does not abate on the appearance of the rash, 

 but continues in a more or less decided degree till 

 that has faded ; it is often attended by delirium. 



Scarlatina anginosa presents in addition to the 

 symptoms above described much more severe affec- 

 tion of the throat, with great pain and swelling. 

 The inflammation is very apt to spread from the 

 throat to the nose and ears : to the latter it is very 

 destructive, life-long deafness often resulting in 

 the case of those who recover from the fever. 

 Sometimes a form of inflammation resembling, if 

 nut iilmtiral with, diphtheria supervenes ; in other 

 cases inflammation and suppuration invade the 

 glands or other tissues in the neck. 



Mnli(/>ii<t >nirliilina is 'so terrible a disease 

 that its characteristic symptoms require a brief 

 special notice. The rash comes out late and im- 

 perfectly, and sometimes is hardly perceptible ; or, 

 Imving appeared, it may suddenly recede ; and 

 sometimes it is intermixed with livid spots. The 

 pulse is feeble, the skin is cold, and there U 

 extreme prostration of strength. In such a case 

 as this death may occur (apparently from blood - 

 poisoning) in a few hours. Other cases rapidly 

 iix-unie a typhus-like character. 



Besides the dangers connected with the severity 

 of the fever, and the results of the throat affec- 

 tion, the chief risk arises from inflammation of the 

 kidneys. It is uncertain whether they become 

 affected in all cases ; in many there is no evidence 

 that they are. But there are none in which the 

 risk of this complication is absent ; and it 

 frequently siipervenes in the mildest forms of 

 the disease, if it has been unrecognised, or if 

 due precautions have not been taken. It is 

 essentially similar to catarrhal nephritis arising 

 from other causes (see KIDNEYS), and may arise 

 at any period till desquamation is completed, 

 but most frequently in the second or third week 

 of the disease. Rheumatic fever not unfrequently 

 follows closely upon scarlet fever. Scarlet fever 

 is rare in infancy and after thirty, most common 

 between two and fifteen. But it is very apt to 

 attack persons suffering from wounds and lying- 

 in women exposed to the infection. It is com- 

 mon in Europe, whence it has been introduced 

 into America and Australasia ; but is rare in Asia, 

 except Asia Minor, and Africa, except Algiers. In 

 the tropical parts of these continents it is almoit 

 unknown ; but in tropical America severe epidemics 

 have often occurred. 



Like all the exanthemata, scarlet fever occurs 

 in epidemics ; and nothing is more remarkable 

 in llii- history of the disease than the extreme 

 variations in severity in different outbreaks. 

 Sometimes the mortality is almost nil ; some- 

 times as many as 30 and 40 per cent, of those 

 attacked succumb. It is undoubtedly caused by 

 a micro-organism (see GERM TIIKORY); but the 



