342 THE DISEASES AND DISOEDERS OE THE OX. 



daily. Tonics must be administered. For at least the first 

 three weeks the diet should consist in chief part of milk, and 

 after that time it is generally recommended that the diet should 

 be good, and include a fair amount of solid food. It is during 

 the period of desquamation that the dangers of rheumatism and 

 of dropsy are greatest. However, in ninety-nine cases out of 

 a hundred rheumatism is an extremely mild affection when 

 occurring in the course of scarlatina. In order to guard 

 against chilling and increased liability to nephritis, the patient 

 should be kept quite warm, and free from exposure to draughts, 

 and he should be confined to bed and clothed in flannel for at 

 least the first three weeks, and the excretory functions should be 

 carefully attended to until the period of desquamation has come 

 to an end. 



In malignant cases and in those in which the muscular 

 debility is great, and there is a tendency to collapse or to the 

 appearance of typhoid symptoms, stimulants are imperatively 

 necessary. Ammonia and brandy are nearly always needed in 

 the malignant cases. Strong tea or coffee, brandy, ether, cam- 

 phor, are to be given internally. Quinine is useful in cases of 

 prolonged adynamia, and a very nutritious diet and a rather 

 liberal allowance of wine will often enable such patients to 

 recover. If there be nasal catarrh with discharge, it is advisable 

 to syringe the nostrils with warm water, or weak solution of 

 chlorate of potassium, nitrate of silver, or some antiseptic. If 

 the throat be ulcerated or gangrenous, solution of perchloride of 

 iron or of nitrate of silver, or hydrochloric acid or nitric acid 

 may be applied, the utmost care being used. 



Warm fomentations or poultices should be employed exter- 

 nally, and if there be suppuration in the glands or connective 

 tissue behind and below the jaw, a puncture or incision may 

 be made, if an actual abscess has formed. In fact, as soon as 

 suppuration has occurred, some advise that an incision 

 should be made to let out the pus, the poultices being after- 

 wards removed. Sometimes openings and counter-openings 

 will be required. If hsemorrhage should occur, the wound is to 

 be stopped with lint soaked in the solution of perchloride of 

 iron. If on the morning of the fifth or sixth day any ulcerous 

 appearance that the fauces may have previously presented does 

 not show signs of yielding, it is well to cauterise the morbid 



