All SCARLFJ KR 53 



membrane i.s noticed, paraoenteais IB 



performed at once. When the ear is discharging, 



uly, high reni fever set* in, for 



i cause can be found by a careful 



'atigation, disease of the maatoid ia suspected. 



In :i, no pain on pressure is, as a rule, 



obtained, and ;>er wall of the meatus does 



Imlge downwards, although, in the subsequent 



operation, the antrum and its surrounding parts 



are i-.tin-l to be full of suppuration. If, therefore, 



the tempi*; remains high, and nothing can 



be found to account for it, trephining the mastoid 



is performed immediately. Delay is out of place, 



as it may lead to the gravest, not infrequently 



fatal, consequences. When any rise of tempera- 



S the heart must be examined for the 



presence of endocarditis, hut the lungs are very 



seldom involved. During the end of the second 



and the beginning of the third weeks, the patient 



needs careful watching. Should any rise of 



temperature, even if only a few points, occur, the 



urine must be carefully tested. It is at this 



iod that hiemorrhagic nephritis begins. It is 



not infrequently found at the same time that the 



glands of the neck are again swollen. This soon 



subsides without leaving any traces. In the 



Charito, the use of prophylactic doses of urotropin 



has been tried, but was found quite nugatory. 



nephritis occurs, the child is given milk 



