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153

OF THE SCARLET FEVER.

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has been very cold, even with frost andsnow for some days. Both»f them have still some swelling of the lymphatic glands on bothides of the neck, extending from the ear almost to the shoulderThis I think the more remarkable, as I could see no ulceration 9the throat, and no particular cutaneous affection on the hairy scalpof either of them. The swelled glands are no longer painful, andare already growing smaller and softer, so I presume they will discuss completely without any difficulty.

" The four year old gentleman whom you enquire after, sick-ened on Monday morning, 14th of November. He had been complaining for five days, much and frequently, both day and night,»f being tired : at day-break on Monday he complained much of theuead-ach, and, upon looking at his skin, he was found to be fromHead to foot as red as a boiled lobster. His puke for two days wasnearly as quick as his elder brother's had been (from 130 to 150),Dut it was not near so strong; nor was his skin ever so hot as hiselder brother's had been. He had no vomiting, or diarrhoea, asboth the others had, but his body continued quite open as in hisperfect health. Supposing the head-ach, which in him .was vensevere, to proceed from the stomach or bowels being in somemeasure load-ed, I gave him, on the afternoon of the secondday, three grains of calomel, which did not operate as a purgebut soon and very effectually as an emetic, and seemed to removehis head-ach; but as this returned on the morning of the thirdday, after being suspended about sixteen hours, two good leecheswere applied to his temples, by which he lost a good deal of blood,with great and immediate relief to the head-ach, which has notreturned.

" The cure in this boy, as in the other two, was trusted to thewashing; but as his pulse was not very strong, nor his heat verygreat, the water was not perfectly cold, though very gently tepid ;so little warm as to make him shiver. It seems to have succeeded aswell with him as with either of his brothers.

" I have had much pleasure in observing repeatedly in theyoungest child (the two year old gentleman) the great and imme-diate good effects of the cold or tepid washing, not only in lesseningthe frequency of the pulse and heat of the skin, but in relieving thefebrile oppression and uneasiness. The little patient, who justbefore was crying very much, unable to hold up his head, incapableof being pleased or amused with any thing, nay almost incapableof looking at any thing, immediately after being washed (I meanin two or three minutes), would begin to look up and take noticeof the people near him; then amuse himself with Ms playthings;then get upon his legs, and run about upon the floor; and at last goquietly to sleep."

The safest and most advantageous time for using the cold affu-sion is when the exacerbation is at its height, or immediately afterits declination has begun. This is generally from six till nineo'clock in the evening ; but may be safely used at any time of theday when there is no sense of chilliness presetit; when the heat o/th