eruption looks uniform, but a closer examination discloses innumerable round points, some of which are more pointed and higher than their neighbors, and often run into minute bladders about the size of a pin's head.
Sometimes the disease is singularly mild; sometimes exceedingly virulent. Sometimes it is so fugacious that its presence is not suspected until the skin begins to peel, a process notably observed on the hands and feet. Frequently the joints, particularly the wrists, suffer pains analogous to those of rheumatism. Scarlet fever is an extremely contagious disease; and while, after ten days' isolation and the use of a bath at the close, a child convalescent from measles may be allowed to associate with others, not less than six weeks' isolation is required to exhaust the communicability of a case of scarlet fever.
Mumps may come on suddenly, or else be preceded by a few days of general indisposition, which now and then amounts to high fever. A feeling of stiffness about the jaws is soon followed by swelling, often very bulky, and more or less tense. The swelling is apt to extend either at the back of the lower jaw or underneath it. The swelling contains no fluid: dental pain is absent. Generally first one side of the jaw is attacked and then the other; it is rare for both sides to suffer simultaneously. Not uncommonly similiar swellings burst out in other localities of the body, the genital organs being most liable to seizure.
Ulcerative stomatitis is a contagious disease. Its invasion may be preceded by general indisposition, usually unattended with fever. Grayish bleeding ulcers, tending to spread in extent and depth, attack the edge of the gums, the inner side of the cheeks and lips, and the roof of the hard and soft palates, accompanied with an extremely fetid breath.
Diphtheritic sore-throat or croup is eminently contagious. Its approach is insidious, often commencing with some difficulty in swallowing and slight hoarseness. Possibly the glands at the back of the angle of the jaw swell, which in serious cases extends to the neighboring structures of the neck. At other times these symptoms occur subsequent to a swelling about the nostrils, with more or less copious discharge, indicating that the nasal membranes have been seized prior to those in the throat. Cough, if any, is faint and muffled; the voice is hoarse and smothered.
With a spoon press down the child's tongue, and note if there be any appearance about the tonsils and the soft palate of a skin or leatherlike membrane, which may be grayish or whitish, or even blackened by vitiated blood. This false membrane, which characterizes the disease, is prone to spread over the neighboring parts, notably reaching downward into the windpipe. This diphtheritic croup must not be confounded with false or spasmodic croup.
In false croup the child has generally been perfectly well during
