- "When to the feeling of general illness which accompanies all fevers is added a very rapid pulse, 120-130. and a temperature of 100°-104°-105°, and there is a dry, hot feeling in the throat, with tonsils red and swollen, and distress on trying to swallow, it is safe to suspect an infectious disease, and probably scarlet fever. The sick person should be isolated at once in a room as much apart from the other members as possible, the higher up in the house the better, and a good physician sent for.
The rash generally appears about the second day, beginning on the neck and chest, and extending over the whole body, the deepest color being on the neck, the outer side of the limbs, the joints, hands and feet. The cheeks are a bright, deep red. The case having been declared to be scarlet fever, all precautions given for infectious diseases, as regards isolation and disinfection, must be observed.
The room should be kept at an even temperature of 65°; light a fire, if possible, and leave the window down an inch at the top. Throw the window open and change the air entirely twice a day, covering the patient head and all at the time and until the room is again warm. Do not be afraid of fresh, dry outside air, but be sure that the patient is covered head and all, so that no cold air is breathed, while you are airing and warming the room.
Give the patient once or twice daily, a warm sponge or plunge bath, as directed by the physician, being careful that he is covered with a blanket during the bathing, thrown over the bed or tub; dry quickly with warm, soft towels, and as the patient lies in bed, rub the entire surface of the body with vaseline, cocoa-oil, or-whatever oil the physician orders. The bed-clothing should be warm, but never heavy; keep the feet and legs warm.
Gruels, milk, simple broth, etc., are generally enough. When there is exhaustion from fever, the doctor will give orders as to stimulating nourish-ment. Cold water or weak lemonade may be given freely, unless the doctor orders differently.
Keep the patient strictly in bed; make use of the bed-pan and urinal to prevent getting up. Guard in every way a check of perspiration. If the patient is propped up in bed, see that a short jacket or small shawl is put over the night-dress, but use nothing that can not be washed.
Notice the breathing at night or in sleep, whether it is even and deep, or short and labored, as if there were trouble with the air-passages. Be particularly watchful of the condition of the excretions, especially of the urine; should it become scanty or smoky-colored, report it at once to the physician. Observe whether there is a free though seemingly harmless discharge from the nose; this may indicate diphtheritic trouble. See whether there is any swelling of limbs. In short, there is nothing which must not be observed with care, and reported accurately to the doctor.
The skin becomes dry, and generally begins to scale off about the fith day after the rash appears. No patient should be allowed to leave his bed until this process is completed. The warm baths should be kept up, the least chilliness guarded against, and the temperature of the room allowed now to be 70°. After the peeling is over the patient should still remain in his room for two? weeks, and should be separate from other members of the family not less than a month from the commencement of the disease. Severe cases of scarlet fever may follow from exposure to light ones. See that the patient is well wrapped, with hands and feet protected, on first going into the open air.
The troubles which may arise out of an attack are frequently the result of carelessness on the part of the nurse, neglect of orders, exposure to cold, etc. There can not be too much care taken of the lightest case. A bad attack will compel attention, but "slight cases," so-called, are often neglected with fatal results, or life-long deafness or other disability. Dropsy, malignant sore throat, disease of the kidneys, weakness of the lungs, pleurisy, and many other maladies, lie in wait for the scarlet fever patient. - Hand-Booh of Nursing.