The mortality was large, owing to the complications just named. Laryngitis and oedema of the glottis were other complications leading to a fatal result. Irrespective of the danger connected with the local affections, the disease was mild, running its course in five or six days. Bleeding and other so-called antiphlogistic measures of treatment appeared to be hurtful. Tonic and supporting measures fulfilled better the therapeutical indications. It was observed that in places where the disease prevailed cases of puerperal fever were also prevalent. It was the general opinion among physicians that the fever was communicable.-A fever accompanied by pharyngitis or inflammation of the throat prevailed in the winter and spring of 1857 in the western part of the state of New York, in the adjacent parts of Pennsylvania, and in Canada. Its usual duration was from three to six days, and it terminated uniformly in recovery. A similar fever prevailed in 1866 among the United States troops stationed at Hart's island, in Long Island sound. It is probable that this fever has occurred at other times and places without having been described by medical writers. The disease as yet has no name.

It differs from acute pharyngitis in that it is manifestly an essential fever; that is, the febrile state is not symptomatic of the local affection, but the latter is secondary to or a complication of the fever. It is analogous to the epidemic erysipelatous fever in the constancy of the pharyngeal affection.

III. Eruptive Fevers.-8. Scarlet Fever, or Scarlatina. This is distinguished from other eruptive fevers by the fact of the eruption being an exanthema, an efflorescence, or a rash, these terms not being strictly applicable to vesicles and pustules. The disease sometimes commences with a chill, and in most cases vomiting is a primary symptom, especially in children. The fever which at once occurs is usually intense, the axillary temperature often rising to 105°, or even higher. The pulse in general is correspondingly frequent. The surface of the body often gives to the touch a burning sensation. The rash appears in about 24 hours after the date of the invasion, and with very few exceptions breaks out first on the face and neck, being diffused over the body in the course of 24 hours. The color of the rash is scarlet, whence the name. The rash in some cases is equally diffused over the whole skin, giving rise to an appearance like that of a boiled lobster. In other cases it is limited to patches varying in number and size, with irregular or serrated margins. The skin is somewhat swollen, and the rash occasions a burning sensation, with in some cases intense itching.

Very generally the eruption takes place in the throat, more or less redness being a](parent here, simultaneously with or before the appearance of the rash on the skin. Generally with the redness there is more or less swelling of the tonsils. Some cases are characterized by severe inflammation of the throat, accompanied by either an ash-colored product or an exudation resembling that which takes place in diphtheria; and with this affection of the throat the glands of the neck become inflamed and sometimes suppurate. When the throat affection is severe the disease has been called scarlatina anginosa. The inflammation in some rare cases extends from the throat into the middle ear, giving rise to perforation of the tympanum, with perhaps loss of the ossicles, and resulting in more or less impairment of the sense of hearing. The cutaneous eruption continues from four to six days. Then follows the stage of desquamation. The cuticle generally in this stage exfoliates, and is separated either in the form of branny scales, or in large flakes or patches. In some instances the cuticle of the hands is separated intact, and may be stripped off like a glove. The itching in this stage is sometimes extremely annoying.

In favorable cases the duration of this stage may be reckoned to be live or six days, when convalescence is established. Frequently, however, this stage is much protracted. Aside from variations in respect of gravity and danger incident to the throat affection, scarlet fever differs greatly in the intensity of the fever and constitutional symptoms. The disease in a certain proportion of cases is extremely mild, the patient perhaps not being confined to the bed. In other cases it is extremely severe, and it may prove fatal within a few days or even hours. In no other disease are the two extremes more widely separated. Death sometimes takes place before the eruption appears. An affection of the kidneys, namely, inflammation of the membrane lining the uriniferous tubes (desquamative or tubal nephritis), is occasionally a concomitant, but oftener a-sequel, of scarlet fever. This local affection may interfere with the excretory function of the kidneys so as to occasion re-tention of urinary principles in the blood, constituting the morbid condition called ura?mia; and this condition may prove serious, giving rise to coma and convulsions. Occurring as a sequel of scarlet fever, this affection of the kidneys leads to general dropsy.

From this the patient recovers, provided fatal effects of uraemia do not take place. Scarlet fever is highly contagious, and it may be communicated by means of fomites. The infectious material remains for a long time in garments, etc, preserving its power of producing the disease. The time which elapses from the reception of the infection before the manifestation of the disease, that is, the period of incubation, is short, sometimes not more than 24 hours, and rarely exceeding a week. As a rule the disease is experienced but once, but exceptions are not very rare. Children are much more susceptible to the special cause than adults. After 40 years of age the susceptibility generally ceases. Children under two years rarely contract the disease.-The treatment in mild cases of scarlet fever is very simple. Active medication is not indicated. It suffices to diminish the animal heat by sponging the body and giving cooling drinks, with such palliative remedies as particular symptoms may denote, observing proper hygienic precautions. In severe cases the use of the cold bath or the wet pack is highly beneficial, not merely as affording relief but diminishing danger. The value in this disease of the direct abstraction of heat by these means lias been very fully established by clinical experience.

Inunction of the surface of the trunk and limbs with fat bacon or some oleaginous preparation allays the itching, which is often very distressing, and in the opinion of some the severity of the disease is thereby much lessened. As in other diseases, whenever the symptoms show failure of the vital powers, supporting measures of treatment (alcoholic stimulants and alimentation) are indicated. There are no known remedies which exert a specific control over this disease, more than over the continued and the other eruptive fevers. Care during convalescence in scarlet fever is considered as especially important with reference to the liability to the affection of the kidneys already referred to. This care relates particularly to exposure to cold; and a fact important to be borne in mind is, that this affection of the kidneys as often follows mild as severe cases of scarlet fever. Belladonna has been supposed to afford protection against this disease after exposure to the infection. This is not certain.

Complete protection can be secured only by avoiding the infection through contact or proximity to patients, and disinfecting everything which may convey it.-For the other eruptive fevers, see Chicken Pox, Smallpox, Measles, and Plague.