392 EKCrPTIVE OE PETECHIAL FEVEES. 



movements are accelerated, and very rapid when congestion of the 

 lungs is present ; the urine is scanty, and of a thick yellow or 

 brownish colour, smelling strongly of hippuric acid, and quickly 

 becoming ammoniacal ; the bowels are constipated, but diarrhoea 

 is easily induced. 



Mr. Haycock describes the malignant form. I am of opinion 

 however, that what he thus describes is purpura, or a combi- 

 nation of purpura and scarlatina, 



For a number of years I was of opinion that purpura and 

 scarlatina were one and the same disease, but I have had 

 occasion to alter this opinion, as typical cases of both diseases 

 are not uncommon in Edinburgh. The distinguishing differ- 

 ences between the two diseases are to be found in the character 

 of — 1st. The petechiffi, wdiich, in scarlatina, are composed of 

 minute dots, forming a blotch by coalescence ; the spots may be 

 as large as in purpura, but each is composed of several smaller 

 ones; they are scarlet in pure scarlatina, of a dark purple in 

 purpura. 2d. The sore throat. This is never absent in scar- 

 latina, and but rarely present, unless it is a symptom of previous 

 disease, in purpura, dd. The swellings. In scarlatina, these 

 are at first in the form of lumps or masses, whereas in purpura 

 they present an even surface, occupying the face, or a whole 

 limb or limbs, and terminate abruptly above, as if a cord had 

 been drawn tightly around the part, 4:th. Scarlatina is often 

 associated with swelling and perhaps suppuration of the glands, 

 whilst in purpura this is not present ; and finally, the latter 

 disease is characterised by a tendency to sloughing in various 

 parts of the body, and occasionally by gangrene of some extreme 

 parts of the organism, such as the ears, which will present a 

 shrivelled and blanched appearance, become dry, and slough, 

 leaving a raw, unhealthy surface. The animal temperature may 

 not distinguish the one disease from the other. If scarlatina be 

 severe, the thermometer may register 103°, or even higher; 

 in purpura this would indicate a mild attack. 



Scarlatina is sometimes followed by inflammation of the 

 joints, which is supposed to be rheumatic in character, and by 

 suppuration in various parts of the body ; but I am not aware 

 that it is succeeded by renal dropsy, or associated with albu- 

 minuria, as in the human being. There is generally more or 

 less oedema of the limbs, breast, and abdomen, but these are not 



