The packing should be repeated
whenever the symptoms increase again; but even if they should not, one
pack and bath a day are necessary.

80. During and after desquamation, the treatment should be continued as
indicated in milder cases, except the throat continue troublesome, when
more packs should be used. If the throat is well, the patient may leave
his room by the sixteenth day, under the precautions given above.

81.--3. TREATMENT OF TORPID FORMS OF SCARLATINA--DIFFERENCE IN THE
TREATMENT POINTED OUT.

When the _reaction_ is _torpid_, the pulse small, weak, quick, the skin
dry, the rash slow to appear, and when it appears in small, pale, livid
spots, instead of bright scarlet patches (16-25); the treatment ought to
be calculated to produce a short, but powerful, stimulus upon the
surface of the body, after which a long pack should assist the organism
in producing a slow, continuous and increasing reaction. If in violent
reaction a repetition of short packs and long cooling baths is
indicated,--in torpid reaction, cold and short tonic baths or affusions
and long packs are required, in proportion to the degree of the reactive
power of the patient. Therefore the packing sheet should be very cold,
but thin and well wrung out, so as to make a strong, but transitory,
impression, soon overcome by the reaction it calls forth, upon which all
our success depends. The patient stays in the pack till he becomes quite
warm and tired. Perspiration is seldom produced; if it is, it may be
considered a favorable symptom. I have had patients stay in the pack for
four, five, six and seven hours, and almost always, when I took them
out, their skin was covered with eruption. The only phenomenon, which
should induce the physician to relieve the patient of the pack before he
becomes perfectly warm, is increased delirium, which in torpid reaction,
indicates a tendency to a typhoid character of the disease, when the
warm and moist atmosphere of the long pack would be more favorable to
the disease than to the patient, by weakening the nerves still more. In
that case, a long half-or sitz-bath is required, the former, under
constant rubbing, from 15 to 20 minutes, the latter from 30 to 40
minutes; the temperature of either from 65 deg. to 70 deg..

82. LENGTH OF PACK.

Usually it is time for the patient to come out from his pack, when the
pulse becomes fuller and stronger, the face begins to flush and the head
to be affected. Freque