In mild cases of scarlet fever the temperature subsides in a few days, and after that time, during the period of desquamation, special care in the diet is unnecessary unless nephritis is present. While the fever lasts the diet should be of fluid character, and milk, koumiss, soups, broths, and farinaceous gruels of arrowroot, farina, etc., are to be given. In all cases there is liability to renal irritation, and desquamative nephritis may occur; and in order to eliminate the scarlatinal poison and waste products of the fever from the system as rapidly as may be, it is advisable that the patient take as little nitrogenous food as possible, except milk, and drink large quantities of fluid. Dryness of the mouth and thirst are prominent symptoms, and there is often difficulty in swallowing, owing to the inflamed condition of the throat. Water, effervescing waters (Seltzer, Apollinaris), barley water, orange juice in Vichy, and sour lemonade may be drunk in considerable quantities.

In mild cases a little plain vanilla ice cream is much enjoyed by children. It is nutritious, cooling, and grateful to the parched throat.

If the fever is high, four or five ounces of fluids must be given every hour. In severe cases there is gastric derangement, and the diet must be restricted to milk in some form, as koumiss or pepto-nised milk. If nephritis is present, the milk diet should be continued, and all other nitrogenous food must be withheld (see Albuminuria). Jaccoud maintains that scarlatinal nephritis can be usually averted by keeping the child upon a strict milk diet from the commencement and continuing it for several weeks.

Convalescent children who have had very mild attacks are often hungry, but it is best to control their diet carefully for two or three weeks, even if albuminuria is not detected. They may be given at first such articles as junket, rice pudding, crackers, farina, cornstarch or sago with cream, milk toast, cream toast, baked custard, blancmange, wine and beef jelly, mush, baked apples, stewed prunes, oranges. The resumption of animal fare should be very gradual in all cases, and fish, oysters, chicken, or eggs should be given before meat.