We sometimes hear of a child, before the eruption comes out and within twenty-four hours of the attack, dying of scarlet fever. When such be the case it is probably owing to low vitality of the system--to utter prostration--he is struck down, as though for death, and if the plan be not adopted of, for a few hours, keeping him alive by heat, and by stimulants, until, indeed, the eruption comes out, he will never rally again, but will die from scarlet fever poisoning and from utter exhaustion. These cases are comparatively rare, but they do, from time to time, occur, and, when they do, they demand exceptional and prompt and energetic means to save them from ending in almost immediate and certain death. "To be forewarned is to be forearmed." [Footnote: I have been reminded of this _exceptional_ case of scarlet fever by a most intelligent and valued patient of mine, who had a child afflicted as above described, and whose child was saved from almost certain death, by a somewhat similar plan of treatment as advised in the text.] 225. _How soon ought a child to be allowed to leave the house after an attack of Scarlet Fever_? He must not be allowed to go out for at least a month from the commencement of the attack, in the summer, and six weeks in the winter; and not even then without the express permission of a medical man. It might be said that this is an unreasonable recommendation: but when it is considered that the whole of the skin generally desquamates, or peels off, and consequently leaves the surface of the body exposed to cold, which cold flies to the kidneys, producing a peculiar and serious disease in them, ending in dropsy, this warning will not be deemed unreasonable. Scarlet fever dropsy, which is really a _formidable disease, generally arises from, the carelessness, the ignorance, and the thoughtlessness of parents in allowing a child to leave the house before the new skin be properly formed and hardened._ Prevention is always better than cure. Thus far with regard to the danger to the child himself. Now, if you please, let me show you the risk of contagion that you inflict upon families, in allowing your child to mix with others before a month at least has elapsed. Bear in mind, a case is quite as contagious, if not more so, while the skin is peeling off, as it was before. Thus, in ten days or a fortnight, there is as much risk of contagion as at the _beginning_ of the disease, and when the fever is at its height. At the conclusion of the month, the old skin has generally all peeled off, and the new skin has taken its place; consequently there will then be less fear of contagion to others. But the contagion of scarlet fever is so subtle and so uncertain in its duration, that it is impossible to fix the exact time when it ceases.