464 On the Epidemics of 1852-8. 
show the early implication of the kidney, for in almost all 
the scarlet fever cases, that is—patients ill in the first week, 
albumen is shown to exist; in the cases after scarlet fever 
and anasarca, it is seen that the urine rises in specific gravity, 
in other words, gets rid of the pent-up urea, which acts, when 
not freely excreted, as a poison, producing anasarca and 
many other eyils. 
It cannot, therefore, be too strongly borne in mind by 
practitioners, that early and constant attention is necessary 
to the functions of the kidneys during all the stages of scar- 
latina. 
The effect of the puerperal condition has been held to be 
SO severe in its operation in scarlet fever that some authori- 
ties say it is always fatal: I was so unfortunate as to have 
two patients die under these circumstances. But in a family 
where the house was small, and all the children, seven in 
number, crowded into two rooms were ill, and one child 
died, the mother “was confined, and had not a bad 
symptom, though she had neyer been the subject of scarlet 
fever. Last year a family was attacked ; one child died 
from affection of the head in scarlet fever, and at that time 
the mother was confined and afterwards attacked with scar- 
let fever. I never saw a milder case than her’s was, 
requiring scarcely any treatment. 
If attention is paid to the state of wounds under the 
influence of scarlet fever, we may have some clue to the 
subject, bearing in mind Dr. Ferguson’s views on puerperal 
' fever. I have known a fracture to remain disunited after an 
attack of scarlet fever; I have seen wounds nearly healed 
protracted in their cure and unhealthy in their appearance 
with the absorption of recent adhesions. 
Not only are mothers carried off by this affection in 
child-bed, but the infant often dies likewise. In the two 
