in handling the diet for fevers in infancy. As
has already been stated, it requires a very slight cause to raise the
temperature of a child, but for this very reason especial care must be
observed that no enlightening symptom escapes the notice of the nurse.

~Complications.~--Tuberculosis or scurvy may be in an incipient stage,
and may be overcome if recognized in time. The nurse has a better
opportunity for observing changes in an infant or child under her care
than the physician who comes once a day or less. The nurse should make
note of these changes, that the physician may have a chance to
regulate the diet accordingly.

~Fluid Diet.~--With children, as with adults, the energy output in
fever is greater than in health, hence the need for plenty of fluids
to help eliminate the waste products due to the increased metabolism.
These fluids may consist of water, fruit beverages, cereal water,
whey, and broth. It is well for the nurse to remember that when the
child is confined to bed, he will not need so much food as he would if
he were up and about, but that if the fever is of long duration, as in
typhoid, the increased rate of metabolism must be met by an increased
amount of food, as the ordinary requirement standards for a child in
health cannot be applied to the diet of a child under these
conditions.

SCARLET FEVER

Scarlet fever is an acute infectious disease, characterized by high
fever, sore throat, a red rash, and a tendency to nephritis. The
disease usually begins suddenly with an attack of vomiting; the
temperature rises to 104 deg. or 105 deg. and on the first or second day a
rash appears, first on the chest and neck, and spreads over the entire
body. This lasts from three to seven days, desquamation begins soon
after the rash disappears and lasts from two weeks to six, the palms
of the hands and soles of the feet peeling last. The appearance of the
tongue is very characteristic, being coated, and through this coating
are seen a few bright red points, producing the well-known strawberry
tongue. After a few days the coating disappears, leaving the tongue
bright red. In mild cases the tonsils are enlarged and the throat very
red. In severe cases there may be difficulty in distinguishing the
disease from diphtheria without a culture being taken. The tendency of
the child to develop nephritis during the second or third week makes
the treatment largely dietetic in character.

~Dietetic Treatment.~--Milk