The tongue is quite distinctive of the affection; early in the
development of the disease it is generally furred, but later the
coating peels off in patches, and these spots present the appearance of
a ripe _strawberry_; sometimes the entire surface of the tongue looks
as if cayenne pepper or red sand had been sprinkled on it.
The fever generally increases during the eruptive stage, and the skin
becomes very dry and hot. The pulse may run up to 130 to 140 per
minute, while the temperature runs up as high as 106° Fahrenheit; this
state of affairs places the patient in imminent danger, he now may
become restless and even delirious. In a certain proportion of cases
the kidneys become involved and albuminuria is a result, but this
usually passes off with the improvement and recovery of the patient.
In the third stage the cuticle begins to exfoliate in the form of
branny scales. In the absence of serious complications this stage marks
the beginning of convalescence; the fever subsides, the appetite
returns, and the soreness and redness of the throat disappear.
The treatment of this affection always depends upon the nature of the
case. Simple scarlatina requires no medical treatment; the precaution
and intelligence which are comprised in good nursing supply everything
that is required. There is not the same danger of the eruption striking
in with scarlatina as there is with measles, and the patient need not
be kept so warmly covered. When the fever runs very high, sponging the
surface with cool water is very grateful and reduces the temperature.
After the eruption has thoroughly developed, the water for sponging off
may be very cold without the least danger, and this may be repeated
as often as comfort or the high temperature demands. To relieve the
burning and itching of the skin, the entire body should be rubbed
over with glycerine night and morning; this relieves the system and
makes the skin moist and supple. If the throat is only reddened, a
teaspoonful of chlorate of potash dissolved in a cupful of hot water
and when cold used as a gargle and a teaspoonful of the solution
swallowed at the same time every two hours is all that is necessary.
The diphtheritic scarlatina is treated precisely similar to and
according to the instructions laid down for diphtheria in another part
of this work. Move the bowels freely with the Femina laxative syrup.