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-_putrid symptoms_ present a good deal of danger, although they give the organism and the physician more time to act. 22. CONDITION OF THE THROAT, AND OTHER INTERNAL ORGANS. The condition of the _throat_ requires the most constant attention. From a highly inflamed state, it often passes into a foul and sloughy condition; the breath of the patient becomes extremely fetid; the nostrils, the parotid and submaxillary glands swell enormously, so that swallowing and breathing become very difficult. There is an acrid discharge from the nose; the gangrenous matter affects the alimentary canal, causing pain in the stomach, the bowels, the kidneys and the bladder; a smarting diarrhoea with excoriation of the anus, and inflammatory symptoms of the vulva. Also the bronchia, lungs, pleura and pericardium become affected, as sneezing, cough (the so-called scarlet-cough) and the pain across the chest and in the region of the heart indicate. 23. OTHER BAD SYMPTOMS. These symptoms may present themselves with the rash standing out; but most frequently they occur when there is little or no eruption, or when it fades, becomes livid, or disappears altogether. A sudden disappearance of the rash, before the sixth day, commonly increases the typhoid symptoms, and must be considered a bad omen. Also the invasion of the larynx, which is happily of rare occurrence, is commonly fatal. 24. DESTRUCTION OF THE ORGAN OF HEARING. When the glands pass into a sloughing state, the parts connected with them are frequently damaged. Thus the ulceration of the parotid gland often causes deafness, by the gangrenous matter communicating to the eustachian tube and the inner ear, where it destroys the membrane of the drum and the little bones belonging thereto, or by closing up the tube. When the discharge from the outer ear is observed, the destruction has already taken place, and it is too late to obviate the injury. 25. OTHER SEQUELS, DROPSY, &C. Beside the ulceration of glands and deafness, some of the sequels of scarlatina are white swelling of one or more of the joints, usually the knee, chronic inflammation of the eyes and eyelids, and partial paralysis. These chiefly occur in scrofulous subjects. Dropsy, which I have mentioned before, is one of the sequels that frequently prove fatal. 26. THE CONTAGION OF SCARLATINA VERY ACTIVE. The _contagion_ of scarlatina is very active, and adheres for a long time to the sick-room, bedd
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