ses off to sleep is quite apt to become
more or less delirious. In the vast majority of cases, after two to four
days of this, the temperature goes down almost as swiftly as it came up,
the rash begins to fade, the throat gets less sore, and the rebound
toward recovery sets in. About this time the daily examination of the
urine will begin to show traces of albumin, but this, under strict rest
in bed and careful diet, will usually diminish and ultimately disappear.
In the event of a relapse, however, or setback from any cause, the
kidneys may become violently attacked, and a considerable per cent of
the fatal cases die from suppression of the urine. After this crisis has
occurred, however, in ninety-nine per cent of all cases it is
comparatively plain sailing; the throat is still sore and troublesome,
the skin itches and tickles, and the eyes smart, but the little patient
steadily improves day by day. Anywhere from three to five days after
the break in the fever the skin begins to get rough and scaly, and
gradually peels off, until in some cases the entire coating of the body
is shed, having been killed, as it were, by the violence of the
eruption. These _flakes and scales of the skin are exceedingly
contagious_, and no case should be regarded as fit to be released from
isolation until every particle has been shed and got rid of. This
constitutes one of the most tiresome and annoying periods of the
disease, as complete shedding is seldom finished before two weeks, and
sometimes may last from three to five.

However, this long period of contagiousness has been found to be really
a blessing in disguise, inasmuch as we now know that even more
strikingly than in the other children's diseases it is the period of
_recovery_ that is the period of _greatest danger_ in scarlet fever.
Like the Parthians of Greek history it is most dangerous when in
retreat. Keeping the child at rest for the greater part of the time, in
bed or on a lounge, in a well-ventilated room, or later on a porch or
terrace, for five weeks from the beginning of the disease, is well worth
all the trouble and inconvenience that it causes, for the sake of the
almost absolute protection it gives against dangerous and even fatal
complications, particularly of the kidneys, heart, or lungs.

This is a fair description of what might be termed an average case of
the disease. We also have the sadly familiar type described as the
fulminant or, literally, "lightning-str