h after the pack, if his
delirium is not removed, or not lessened in half an hour or
three-quarters of an hour. This alternating with the pack and sitz-bath
should be repeated, till the head becomes clear.

77. In excessive heat and continuous delirium, a half-bath may be given,
also, every time the packing sheet is changed. The rule is that _we_
ought not to yield, but the _symptoms must_; and they will, if the
treatment is persevered in. Only go at it with courage and confidence.
There is nothing to be apprehended from the treatment: where there is
too much heat, there is no danger of a lack of reaction, and
consequently no occasion for fears that the rash might be "driven in." A
physician afraid of using water freely in violent cases of
scarlet-fever, would resemble a fireman afraid of using his engine, for
fear of spoiling the house on fire.

78. ACTION OF THE SITZ-BATH EXPLAINED.

The _sitz-bath_ acts in a direct manner upon the abdominal organs and
the spine, and through the latter on the brain. Indirectly, it helps in
removing the inflammatory and congestive symptoms in the throat and
head, by cooling the blood, which circulates through the parts immersed
in the water, and by doing so cools also the upper parts of the body,
equalizes the temperature, and diminishes the volume of the mass of the
blood, thus making its circulation easier, _whilst it has no tendency to
impede the action of the skin_. Besides, the abstraction of electricity,
by the sitz-bath, should be taken in account of its action. After the
sitz-bath, the reaction takes place in those parts which were immersed
in the water, thereby making the relief of the upper parts more lasting.

79. RELAXATION OF TREATMENT TOWARDS THE END OF THE THIRD
PERIOD--CONTINUATION OF PACKS DURING AND AFTER DESQUAMATION.

When the patient is through the first part of the period of
efflorescence the symptoms decrease, and he will be easier. Under the
treatment prescribed, the time when the excitement is highest, is much
abridged, and usually the treatment can be relaxed in less than
twenty-four hours. When the patient is easier, the treatment may be
given as in the milder form of scarlatina anginosa, with due regard to
the state of the throat. In proportion as the heat abates, the packs
should not be repeated so often, the sheet not changed; the patient
should stay longer in the packs, and the baths should be shorter. The
sitz-bath would then be out of season.