Scarlatina, is generally a contagious epidemic, seldom attacking persons but once, and more frequently seizing its victims from the ranks of childhood. The cheek of many a mother has grown pale with terror as she heard the news of its approach, and gathering her children around her, she has fled from the neighborhood tainted by its presence, as from the breath of a pestilence. In severe cases the rapidity of its progress, often running its course in two or three days, and where the termination is not fatal, the danger of its leaving behind some chronic difficulty, are enough to cause it to be dreaded in every community. The treatment of this disease with a success hitherto unknown, and in many cases its prevention did much towards turning the attention of the public to Hahnemann, and that great law of cure, which is now pervading every land.

Diagnosis

The genuine Scarlatina seldom attacks persons beyond the age of twelve, and is now generally met with in complication with scarlet rash or some other disease. The eruption is like the redness of erysepelas, of a fiery bright, scarlet red, or resembling the color of a boiled lobster, turning white under pressure of the finger, but speedily, on the finger being removed, resuming its original color. The boundaries of this redness are not distinctly defined, but are imperceptibly lost in the surrounding white parts. The red skin is perfectly smooth and glossy, the redness from time to time increasing or diminishing in extent and intensity. The eruption commences on the uncovered parts, or those slightly covered, as the face, neck, hands, arms, chest and feet, is accompanied with swelling, and gradually spreads over the body. Simultaneous with the redness, the heat and fever appear, continuing, in simple cases, three or four days, and in malignant ones, about seven, when the eruption gradually becomes paler and paler until it entirely disappears. The more extensive and intense the redness, the more violent the fever. With the disappearance of the redness and the abatement of the fever commences the stage of desquamation when the epidermis peals off in large patches. In connection with the fever, dryness of the mouth, severe soreness and often ulceration of the throat exist. A severe form of the fever is often preceded by vomiting. If the disease is combined with scarlet rash, instead of the skin presenting a smooth shining appearance, the roughness of the eruption is distinctly felt on passing the hand over the surface. This disease was formerly, frequently mistaken for measles, but to the careful observer the distinctive marks are sufficiently plain. Independent of the eruption, the soreness of the throat present in scarlatina, is absent in measles, and the catarrhal symptoms, which are present at the outset of measles are not observed in the commencement of scarlet fever.

Treatment

Belladonna is the specific in the true form of this disease, a few doses of which will often afford decided and permanent relief. There is fever, quickness of the pulse, dryness of the mouth and thirst, throat highly inflamed and swollen; spasmodic contraction of the throat, danger of suffocation, and inability to swallow the least liquid; thirst, red and dry tongue, inflamed and painful eyes; pressure over the eyes or shooting in the head; starts and jerks on closing the eyes, sleeplessness with great nervous excitement. The external redness does not always appear, but in these cases the throat is swollen and painful, and the tongue presents a bright red appearance.

Dose

Two drops, or six globules, of the remedy should be dissolved in a tumbler of water and a tablespoonful given every two or three hours, according to the severity of the symptoms. Should the symptoms be accompanied with fever, dry heat, bilious vomiting, etc, especially in the commencement of the disease, Aconite may be alternated with the Belladonna, one or two hours apart. Stibium may also be indicated in the same manner, a powder given in alternation with Belladonna, when the Aconite proves unavailing, and when there is a stupid condition, great heat, nausea, vomiting, convulsions or spasmodic jerks and imperfect development of the eruption. If the symptoms should become worse shortly after the administration of the Belladonna, it may be suspended, and the article in the Introduction, on the administration of remedies, be consulted. If the increase of symptoms are an aggravation of the remedy, the system will soon react, if however they are aggravations of the disease, other remedies will be necessary.

Mercurius - Is a prominent remedy in the malignant form of the disease, where there is great inflammation about the throat, swelling and ulceration of the glands, accompanied by an offensive smell, salivation and ulceration of the mouth. It may be given after or in alternation with Belladonna, two hours apart.

Dose

A powder, or three globules, dry on the tongue. If after the expiration of twelve or fourteen hours no improvement is manifest, but the restlessness increases and the saliva becomes more offensive, Lachesis and Arsenic may be given in alternation, in the same manner as the Mercurius, one or two hours apart, until five or six doses of each have been taken or until a change is indicated.

Arsenic - Will be indicated, where there is great prostration of strength, distorted features, nightly burning fever, gangrene of the throat, as well as in the various forms of dropsy caused by this disease.

Dose

A powder, or three globules, may be given every three hours.

Capsicum

is also a useful remedy, when there is redness of the face, alternating with paleness; violent sore throat, painful swallowing, and contraction and spasm in the throat, pains in the neck, sneezing, hoarseness, hacking cough and accumulation of tough mucus in the throat.

Dose

One drop, or six globules, may be dissolved in a tumbler of water, and a spoonful given every two or three hours.

Coffea - Is often indicated in alternation with Belladonna, when there is great restlessness, irritability and whining mood, particularly at night. They may be alternated one or two hours apart.

Dose

One drop, or six globules, in a glass half full of water a teaspoon at a dose.

Rhus - Will be found useful, when the disease assumes a vesicular form, and is accompanied with restlessness, staits, thirst, and dry tongue.

Dose

Same as Belladonna. Give every one or two hours.

Muriatic-acid is another prominent remedy in the malignant form of this disease, as well as in certain varieties of Typhoid Fever. It is indicated, where there is severe ulceration of the throat, fetid breath, acrid discharge from the nose, soreness and blisters about the nose and lips, efflorescence of an irregular and faint color, changing to a dark red, frequently intermixed with petechiae; flushing of the check, and dull redness of the eyes. It is more frequently indicated after Mer-curius and Lachesis, particularly if those remedies have in a measure failed of producing good results.

Dose

Sufficient of Muriatic-acid may be put in a tumbler of water, to make it very slightly tart, and a teaspoonful given every two or three hours.

Nitric-Acid

May also be thought of, when the swelling and ulceration are severe.

Opium

This remedy will be found useful where there is snoring sleep, great restlessress, sometimes with vomiting or constipation, burning heat, and stupefaction.

Dose

Same as Belladonna. Give once in two or three hours.

Sulphur - Will prove beneficial where there is lethargic sleep, starts or constant delirium, puffed red face; red, dry and cracked tongue, great thirst; cerebral affections, which do not yield readily to Belladonna.

Dose

A powder, or three globules, may be given every two or three hours until three doses have been taken, then select some other remedy.

Secondary Diseases Succeeding Scarlatina

Severe pain in the ear will generally be relieved by Pulsatilla, one drop, or four globules, dissolved in a glass of water, and a tablespoonful taken every two or three hours, until four or five doses have been taken. If this not does produce relief, alternate Belladonna, prepared in the same manner, and Hepar-sulph., a powder, or three globules, one hour apart

The running at the ear will generally be controlled by Calcarea, a powder, or three globules, every six hours.

Fetid discharge at the nose, and pain in the nasal bones will be relieved by a few doses of Aurum, a powder, or three globules, at intervals of four or six hours.

Merourius will be found beneficial, where there is ulceration of the face or throat; a powder, or three globules, three times a day to be followed, if necessary, after three or four days, Sil. Calc., Hep.-s., Sulph, or Iod.

Digitalis is of benefit when there an indications of dropsy of the chest, such as oppressed breathing, thin and weak pulse. Give same as Hellebore.

Should there be symptoms of dropsy of the drain, such as, great heat about the head, cold extremities, vomiting on moving, Belladonna and Hellebore may be given, one drop, or six globules, dissolved in a glass half full of water, and a teaspoonful administered in alternation every two hours.

In cases of dropsical swelling of the body, or the extremities, I have found great benefit from an alkaline bath. The water, comfortably tepid, is made sufficiently alkaline, to be perceptible to the taste, by dissolving in it Pearlash or Saleratus. In this bath the patient may be placed once or twice a day, being permitted to remain four or five minutes.

Hellebore. and Belladonna, as directed above, may be given in alternation four hours apart. Should the difficulty still continue, after three or four days, Arsenic or Phos.-ac. given at intervals of six hours, will generally complete the cure.

Croupy cough will be relieved by a few doses of Hepar-s. given every four hours. During the administration of these remedies, the patient should be very careful to avoid taking cold.

Prevention

During the prevalence of the scarlet fever, the attack may frequently by warded off entirely, or the disease rendered comparatively harmless, by administering every evening three globules of Belladonna, for one or two weeks. I have always found as a preventive the higher attenuations of this remedy far more beneficial, than the lower.

Diet And Regimen

Diet should he simple, such as gruels, toast, etc, returning gradually and carefully to more nourishing food. The room, of course, should be well ventilated, and yet the patient strictly guarded against taking cold. A particular caution is also necessary about going out too early as often serious secondary disturbances are occasioned by a want of proper prudence.