332 THE DISEASES AND DISORDERS OF THE OX. 



we shall again recur. The virus of scarlet fever is of a power- 

 fully infectious nature, and it may be conveyed from an infected 

 person to others by the medium of the clothes, the furniture, 

 and so forth, and it is to be borne in mind that the infective 

 properties persist for a long time. Apparently the virus may be 

 carried great distances by the medium of the air — at any rate, 

 through the dimensions of a large ward, and also doubtless 

 even from the hospital to the neighbourhood which immediately 

 surrounds it. It clings to clothes with great tenacity, and may 

 thus lie latent for an indefinite period, and it is liable to infect 

 milk and other articles of food. The fever may be transmitted 

 by infection or by direct inoculation. Women at the time of 

 parturition are very liable to take the infection, possibly 

 receiving it, it has been suggested, directly from the fingers of 

 the accoucheur in some instances. The infectiousness of the fever 

 is greatest when the rash and the sore throat are developed, and it 

 certainly does not cease until desquamation has been completed. 



The period of incubation in the case of scarlet fever is shorter 

 than that of most diseases of the same class. It usually varies 

 from six to eight days ; but it is sometimes longer, and very 

 frequently less, and may be as little as twenty-four hours. It is 

 especially in the case of puerperal women, and probably also in 

 that of persons suffering from large wounds, that the latent period 

 seems to be of very short duration. The fever varies wonder- 

 fully in regard to the degree of its severity, in the symptoms ; 

 and, when death occurs, in the cause which finally brings it 

 on, and the time at which the fatal result ensues. The onset of 

 the disease is sudden, the first noticeable signs being chills, 

 sore throaty vomitbif/, dryness of skin, drowsiness, headache in 

 the region of the forehead, giddiness, aching of the limbs, 

 coating of the tongue, thirst, loss of appetite^, and sometimes 

 also diarrhoea. The pulse at first is very rapid. 



There is reason to believe that the irritation of the throat is 

 in some measure a cause of the vomiting which occurs at an 

 early stage in cases of scarlet fever, and since vomiting also 

 occurs at the onset of diphtheria and small-pox, in which the 

 fauces are attacked, and also closely follows the onset of inflam- 

 mation of the fiiuces, it seems as if in all those cases the irrita- 

 tion is at least in part a cause of the vomiting. (Dr. D. 

 Astley Gresswell.) 



