the end of two or
three days, and then gradually declines. In some cases the rash is seen
only twenty-four hours.

Fever.--The fever rises rapidly in the first few hours to 104 or 105-8/10
degrees. It remains high except in the morning, until the eruption reaches
its full development and falls with the fading eruption, and in
uncomplicated and typical cases, within six days becomes normal.

[INFECTIOUS DISEASES 169]

Sore Throat.--This we find on the pillars of the fauces, uvula, tonsils,
and pharynx, reddened and inflamed. Sometimes it is very severe, and a
membrane comes on one or both tonsils and pillars of the fauces. There is,
generally a severe sore throat, and this makes swallowing difficult.

Tongue.--The tongue is covered with a coating at the onset, and may
present a slightly reddened appearance at the borders and tip. The
papillae are prominent and covered and look like a strawberry sometimes,
or like the tongue of a cat. In fatal poisonous cases it becomes dry and
cracked.

Scaling.--As the disease subsides the outer layer of the skin dries and
peels off. The extent of this depends upon the severity of the attack. In
some cases the scaling is hardly perceptible, and sometimes it appears
only on certain parts, such as on the toes and inner parts of the thighs.
There is always some scaling. This is called "desquamation." Generally
speaking, scaling begins where the eruption first appeared on the upper
part of the chest and neck. The scales may be fine and branny or as is
most common, the skin peels in large particles. Some scaling is always
present. The length of the scaling time is variable. It usually lasts from
three to four weeks, but often longer. This stage is considered by many as
the most contagious, as the fine scales fly in the air.

Complications. Nose.--The nose is affected at the same time if the "sore
throat" is very severe. A membrane may also form in the nose.

Ear.--This may be affected in as high as one-fifth of the cases and needs
careful watching and attention. Both ears may be diseased and deafness
frequently results from it. Ten per cent of those who suffer from
"deaf-mutism" can trace their affliction to scarlet fever. The ears
usually become afflicted in the third week. The fever rises and there is
pain in the ears or ear. The onset may not appear alarming and not be
suspected until the discharge makes its appearance This is unfortunate;
these complications are serious, as menin