Scarlet Fever, or Scarlatina, is one of the commonest of the infectious fevers. It is particularly liable to attack children and young adults, and it spreads directly from the sick to the healthy, the infected period lasting for many weeks. Up till quite recently the general idea was that the chief infection lay in the dried-up particles of skin which peel off in convalescence. But recent research rather points to infection spreading from the discharge of the nose, ear, and throat as long as any such discharge exists. It is found that the infective matter will lurk for weeks and months in bed-clothing or books. Milk is a very common vehicle of infection.

The incubation period, or the time which elapses between contracting infection and the appearance of symptoms, is very short, and in many cases may be only two days. As a rule, the symptoms appear suddenly, with perhaps shivering, sickness, or vomiting. Sore throat is an early symptom, and the temperature rises rapidly. The throat is red in colour, and the tongue also has quite a strawberry appearance. The eruption, or rash, appears two or three days after the temperature rises - first on the chest, and later on other parts of the body. It is a bluish red rash formed by the massing together of minute scarlet spots on a pink background. In a few days the symptoms of fever disappear, the rash fades, and peeling sets in.

The chief complications of scarlet fever are inflammation of the kidneys, rheumatism, and middle-ear disease.

The doctor will order the patient to retire to bed immediately, properly isolated from the rest of the family in those cases where he cannot be taken to hospital. Milk and barley-water are the only articles of food permitted in the early stages. The throat will require regular gargling, and if there is much pain, the neck should be wrapped in cotton-wool or poulticed with linseed-meal. Various details connected with the nursing of scarlet fever were considered under the series of infectious ailments in the Home Nursing Section. Every care should be taken that the patient is guarded against chill, in order to avoid kidney complications, which are always serious in scarlet fever.

It ought to be said that there are several varieties of scarlet fever. The above description refers to the simple or ordinary type, and there is a milder form, when the rash and sore throat may be absent, and the disease is not suspected until peeling, or desquamation, sets in. These are the most dangerous cases from the epidemic point of view as the patients are not isolated, and may infect many healthy people.

The severer forms of scarlet fever include the septic form, where there is ulceration of the throat; the malignant, or typhoid, scarlet fever, accompanied by low, muttering delirium; and the haemorrhagic type, where red haemorrhagic spots appear underneath the skin.

Patients must be regarded as infectious for about six weeks, and must be isolated until desquamation has ceased, and there is no discharge from the ear, nose, or throat. It is of the greatest importance to keep the patient in bed for three weeks, so as to avoid the danger of inflammation of the kidneys.

Whenever possible, cases of scarlet fever should be treated in hospital, where proper hygienic conditions prevail, and the patient has a much better chance of a good recovery. Delicate children, and women recovering after childbirth, are specially liable to infection, and must be immediately protected whenever a case occurs in their near neighbourhood. One attack usually confers immunity for life. The disease is most prevalent during the autumn and early winter, when epidemics are liable to occur.

Sciatica is a painful inflammation of the sciatic nerve, which passes down the back of the thigh and leg. The nerve is tender, and movement gives great pain, which is of a shooting character, and may penetrate right down to the foot. Walking and sitting are sometimes difficult from the pain they cause. There are many causes which may account for sciatica. An ordinary cold or chill will affect the sciatic nerve, whilst neuritis may be the initial cause. The disease may be of rheumatic or gouty origin, whilst pressure at any part will cause this shooting pain along the whole course of the nerve.

In many cases the cause cannot be discovered, and treatment must be directed towards relieving the pain. When this is very acute, the thigh should be wrapped in a hot pack, the making of which was described under the Home Nursing section. The application of an ordinary hot fomentation of flannel wrung out of boiling water and sprinkled with laudanum will also relieve the pain. Dry-heat applications are useful in the form of hot sandbags, hot bottles, or hot plates. One of the best medical applications is aconite, belladonna and chloroform liniment, commonly called A.b.c. liniment, which contains equal parts of the three ingredients. It is a mistake to take any internal medicines to ease the pain, except by a doctor's orders. Electric treatment or blistering will be found best when the disease is chronic.

The earlier treatment is undertaken, the better, as, when neglected, sciatica may persist for months or years. Rest is a more important measure. Care should be taken to avoid constipation, as this in itself, if severe, may cause sciatica in a neurotic person.

Scurf. (See Dandruff.)

Scurvy was in former days a very common disease, especially amongst sailors, who had to live for months on tinned foods on long voyages. It is due to improper feeding, so that nowadays it is chiefly seen in young children who have been badly managed, or amongst the very poor. The cause of the disease is due to the absence of fresh fruit and vegetables in the diet. When this fact was discovered, and lemon-juice or lime-juice was given to the sailors, the disease entirely disappeared from the Navy.

In the case of children, the chief symptoms are pallor, debility, weakness, and tenderness of the gums. These may ulcerate and bleed, and haemorrhage may take place from other parts of the body, such as the nose or stomach. But the disease is rarely seen in so extreme a form. As a rule, the child is pale, weak, flabby, and apparently with very little muscular strength. The disease may be associated with rickets (which see), and the treatment for both conditions is very much the same. To be continued.