Page:The physical training of children (IA 39002011126464.med.yale.edu).pdf/217

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entirely to the plan I have just recommended, and in not allowing my patients to leave the house under the month—until, in fact, the skin that has peeled off has been renewed.

Let us now sum up the plan I adopt:

1. Thorough ventilation, a cool room, and scant clothes on the bed, for the first five or six days.

2. A change of temperature of the skin to be carefully regarded. As soon as the skin is cool, closing the windows, and putting additional clothing on the bed.

3. The acidulated infusion of roses with syrup is the medicine for scarlet fever.

4. Purgatives to be religiously avoided for the first ten days at least, and even afterward, unless there be absolute necessity.

5. Leeches, blisters, emetics, cold and tepid spongings, and painting the tonsils with caustic, inadmissible in scarlet fever.

6. A strict antiphlogistic (low) diet for the first few days, during which time cold water to be given ad libitum.

7. The patient not to leave the house in the summer under the month; in the winter, under six weeks.

What NOT to do.—Do not, then, apply either leeches or blisters to the throat; do not paint the tonsils with caustic; do not give aperients; do not, on any account, give either calomel or emetic tartar; do not, for the first few days of the illness, be afraid of cold air to the skin, and of cold water as a beverage; do not, emphatically let me say, do not let the child leave the house for at least a month from the commencement of the illness.

My firm conviction is, that purgatives, emetics, and blisters, by depressing the patient, sometimes cause ordinary scarlet fever to degenerate into malignant scarlet fever.

I am aware that some of our first authorities advocate