SCARLET FEVER. 41 



considerable enlargement of the glands of the neck. This enlargement of the glands 

 of the neck is said to be distinctive of this form of the disease, but such an assertion 

 is scarcely warrantable. Impetigo at least some forms of it is contagious, and has 

 been conveyed from one child to another by exchange of head-dresses. Care should 

 therefore be taken to keep a child with this malady away from school, and separated 

 from its fellows for a time. 



The treatment of these two conditions consists, first, in removing the cause, if any 

 such exist in a tangible form. A careful search must be made in every case for the 

 presence of lice or nits in the head, and if such exist they must be destroyed by 

 the application of carbolic acid and oil (one part to ten), or of white precipitate 

 ointment. The next point in the treatment is cleanliness. The hair should be cut 

 off, and the scalp should be thoroughly cleansed of all crusts and scabs by prolonged 

 bathing and soaking with warm water. This being done, the head is in a fit state 

 for the application of remedies, but it is of 110 use to apply remedies to heads which 

 have not been previously cleaned. The best application for eczema is zinc ointment, 

 which should be very gently applied to the part with the point of the finger, the head 

 being then covered with a skull-cap made of rag or linen. For impetigo, the best 

 application is probably the nitrate of mercury ointment, which should be applied in 

 the same way. The head must be thoroughly and completely cleansed night and 

 morning and even though it take hours, it will be time well spent. It is well not to 

 be afraid of cutting off the hair, and it is advisable to cut very wide of the disease. 

 In cases of eczema of the scalp, it is recommended that the head should be washed 

 with oatmeal and water instead of soap, as being less irritating. 



Internal remedies and constitutional treatment must not be neglected, for it will 

 be found that these diseases do not get well without them. In cases of impetigo, 

 the administration of quinine often acts like a charm, and under its influence the 

 trouble ceases at once. It is often necessary to precede the tonic treatment by .'a 

 brisk purgative, and a dose of grey powder and jalap is often administered with 

 benefit. The various remedies mentioned for the treatment of scrofula are of service 

 in these diseases. The diet must be carefully supervised, and every precaution taken 

 to prevent the children stuffing themselves with trash. 



Scarlet Fever. This is one of the most fatal of the diseases to which we are 

 liable, especially in childhood, and when the disease becomes ppidemic the mortality 

 which it causes is often really terrible. It is the dreaded scourge of some families, 

 -and it is one of the well-recognised peculiarities of the disease that it falls upon some 

 constitutions far more heavily than upon others. 



The great cause of scarlet fever is contagion, and one person suffering from the 

 disease becomes a centre of infection to others. There seem to be states of atmo- 

 sphere, epidemic conditions in which the disease is more easily spread than at other 

 times ; but whenever a case of scarlet fever occurs it is generally not difficult, 

 if diligent search be made, to point with certainty to the source from which the 

 poison has emanated. The healthy should hold no communication with scarlet-fever 

 patients unless they themselves have already had the disease, and have thus earned 

 an immunity from further attacks. Those in attendance upon scarlet-fever patients 



