34 PRACTICE OF MEDICINE. 



measles is, a short hoarse and barking cough, which has a great deal 

 of the croupy sound, but is not attended with dyspnoea. It readily 

 yields to counter-irritants. 



SCARLATINA. 



This is a contagious fever, particularly affecting the skin and mu- 

 cous membrane of the throat. About the second day of the affec- 

 tion, the whole surface of the body presents little red 'points^ which 

 are soon followed by patches of a deep scarlet colour^ serrated at 

 their edges, which become confluent, and terminate by desquamation 

 on the fiflh or sixth day. 



Scarlatina occurs under three forms — Scarlatina simplex, S. an- 

 ginosa, and S. maligna. 



SCARLATINA SIMPLEX. 



The precursory symptoms of this form are, general debility, 

 nausea, shiverings, followed by flushes of heat and thirst. On the 

 second day of the febrile symptoms, little points^ at first of a light 

 red, then becoming deeper, appear in great numbers on the face, 

 neck, and chest. In the course of twenty-four hours, similar spots 

 appear on the body, lips, tongue, palate, and pharynx. On the 

 third day, most of the interstices which had been lefl are covered 

 with large dotted patches, having serrated edges. In this stage, the 

 pulse is full and frequent, the tongue is covered with a creamy coat, 

 through which the red and elevated papillae appear. This produces 

 the peculiar appearance of the organ to which the term straivberry- 

 like tongue is applied. The skin is much hotter in this form of ex- 

 anthema than in any other. The scarlet colour is of a deeper tint 

 on the groins, buttocks, and folds of the joints, than in other situation*. 



About the ffth day the interstices between the patches become 

 larger, the scarlet colour less vivid, and slight desquamation takes 

 place on the neck, temples, and chest. On the sixth day, the cha- 

 racter of the disease becomes less distinct ; and on the eighth and 

 ninth days, desquamation from the surface of the hands, feet, and 

 the different regions of the body, takes place. 



SCARLATINA ANGINOSA. 



Symptoms. — This form commences with more intense fever, and 

 a sense of stiffness of the neck and inferior maxilla. On the second 

 day, the pharynx is inflamed, deglutition is difficult, the amygdalce 

 become swollen, and the mucous membrane presents a vivid red 

 appearance. In the S. simplex, the pharynx presents an exanthe- 

 matous blush, but there is no effusion ; in this form, however, a 

 quantity of thick, viscid fluid, sometimes of a whitish-yellow colour, 

 but more generally, caseous-like matter, is thrown out on the amyg- 

 dalse, pharynx, and anterior pillars of velum. During the second^ 



