Scarlet fever is an exanthematous form of disease distinguished by a scarlet eruption of the skin. It produces marked symptoms in three localities, the skin the throat and the kidneys.
It is doubtful whether it can be conveyed from one person to another; at least nothing is known concerning the "contagium," or germ of conveyance of infection,--according to the differential diagnosis of Dr. G. Kuhnemann, whose work on the subject is held to be authoritative. It is not to be denied that the disease may be carried by articles of clothing and by intermediary persons, who themselves are not suffering from it.
The incubation period--the time intervening between infection and eruption--during which the infected person is "sickening for" disease, varies from two to as much as eight days.
Chills, feverishness, headache, nausea and actual vomiting are the initial symptoms, and sore throat with difficulty in swallowing soon follow.
Inspection reveals the appearance of an acute throat inflammation, and the tip and sides of the tongue are red as a raspberry. A few hours later--or at most a day or two--the eruption appears; first in the throat, then on the face and chest. It begins with minute, bright red, scattered spots, steadily growing larger until they run together so that the entire skin becomes scarlet, being completely covered with them. Frequently the temperature in the evening ranges as high as from 103° to 105° Fahrenheit. Albumen is always found in the urine.
After two or more days the fever mounts gradually, the throat symptoms increase, the eruption fades away, and from four to eight days later the patient's condition returns to normal.
At the beginning of the second week desquamation, or scaling, begins, the skin peeling off in minute flakes. At this stage heavy sweats set in and the excretion of urine is increased.
In epidemic form the type is sometimes much more malignant, even to the degree that death occurs on the first day with typhoid and inflammatory brain symptoms, unconsciousness, convulsions, delirium, excessive temperature, and rapid pulse. This may happen even without the eruption becoming fairly recognizable. In such severe epidemics the throat symptoms are apt to take on the aspect of diphtheria. The renal discharge exhibits the conditions of a catarrh of the urinary canals originating from causes we do not understand.