the situation of the patient becomes critical.

6. PERIOD OF DESQUAMATION, OR PEELING-OFF.

About the sixth or seventh day, the epidermis, or cuticle of the skin begins to peal off, commencing in those places which first became the seat of the rash, and gradually continuing all over the body. In such parts as are covered with a thin delicate cuticle (as the face, breast, &c.) the cuticle comes off in small dry scurfs; in such parts as are covered with a thicker epidermis, in large flakes. There have been instances of almost complete gloves and slippers coming away from patients' hands and feet.—The fever subsides entirely, and so does the inflammation of the throat and mouth, which become moist again. Also the epithelia, or the delicate cuticles of the mucous membranes, which have been affected by the disease, peal off and are coughed up with the tough thick mucus covering the throat, or they are evacuated with the fæces and the urine, forming a sediment in the latter.—Desquamation is usually completed in from three to five days; sometimes it requires a longer time; under hydriatic treatment it seldom lasts more than a few days. Whilst desquamation is taking place, a new cuticle forms itself, which, being exceedingly thin at first, gives the patient a redder color than usual for some time, and requires him to be cautious, in order to prevent bad consequences from exposure.—

Thus the disease makes its regular course in about ten days, and, under a course of hydriatic treatment, which not only assists the organism in throwing off the morbid poison and keeps the patient in good condition, but also protects him from the influence of the atmosphere, the patient may consider himself out of danger and leave the sick-room under proper caution, of which we shall speak hereafter.

7. THE PERIOD OF CONVALESCENCE,

under the usual drug-treatment, is, however, usually protracted to twice or thrice the duration of the disease, the patient being compelled to keep the house for five or six weeks, especially from fear of anasarca, or dropsy of the skin, frequently extending to the inner cavities of the body, and proving fatal. This dangerous complaint has been more frequently observed after mild cases of scarlet-fever than after malignant cases, probably from the fact that in mild cases the patient is more apt to expose himself, than when the danger is more obvious and all possible care is taken.—Sometimes also severe rheumatic pain, or rather neuralgia, in the joints, swelling of the glands, and other sequels prolong his sickness. I never observed a case of dropsy, or of neuralgia, after a course of water-treatment.

8. VARIETIES OF FORMS OF SCARLATINA.

The above is the description of scarlet-fever, as it most frequently occurs. But far from taking always that regular course, the constitution of the patient, the intensity of the epidemy and the virulence of the poison, the treatment and other circumstances influencing the development of the disease, cause several anomalies, from scarlatina simplex to scarlatina maligna, which too often baffles all the resources of the Medical Art.

9. SCARLATINA SIMPLEX, OR SIMPLE SCARLET-FEVER.

In the mildest form of the disease, called scarlatina simplex, or simple scarlet-fever, there is no inflammation of the throat, the fever is moderate, and the patient suffers very little. Unfortunately this form is so rare, that many experienced physicians never saw a case. Probably, it was a case belonging to this class, which was mentioned a number of years ago by one of the writers on Priessnitz's practice, when a lady with scarlet-fever joined a dancing party at Græfenberg, a case for reporting which the author[2] has been ridiculed by the opponents of the Water-Cure, but which by no means belongs to impossibilities; for scarlatina simplex having been declared by eminent physicians (not of Priessnitz's school) to be "scarcely a disease,"[3] becoming fatal only through the officiousness of the doctor,[4] and other physicians of note recommending cold rooms and open air through the whole course of the disease,[5] or at least towards the latter part of it;[6] I do not see why a patient under water-treatment should not be safer in producing perspiration by dancing than in sitting in a cold room or in walking in the open street. The fact, of course, is unusual, and I do not exactly recommend its practice, but it is not at all impossible, and ridiculing the reporter of it shows either ignorance of the disease or a bad will towards the new curative system, to which those are most opposed who know the least of it.

10. SCARLATINA ANGINOSA, OR SORE-THROAT SCARLET-FEVER.

Wherever the throat is affected, which is almost always the case, the disease is called scarlatina anginosa, or sore-throat scarlet-fever. This is the form described at the commencement of this article. There are several varieties, however, of scarlatina anginosa.

In any case, the organism, invaded by the contagious poison, will try to rid itself of its enemy. The reaction is necessarily in proportion to the violence of the miasma and to the quantity of organic power struggling against it.

11. MILD REACTION (ERETHIC).

If the poison is not virulent, and the body of the patient in a favorable condition, the reaction is mild, and the poison is eliminated without any violent efforts on the part of the organism. This is the case in scarlatina simplex, and in mild forms of scarlatina anginosa.

12. VIOLENT REACTION (STHENIC).

If both, the contagious poison and the organism, are very strong, a violent reaction will take place, and the safety of the patient will be endangered by the very violence of the struggle, by which internal organs may be more or less affected.

13. TORPID REACTION (ASTHENIC).

The more violent the contagious poison, and the weaker the organic power, the less decidedly and the less successfully will the organism combat against the poison, and the more inroad will the latter make upon the system, affecting vital organs and paralyzing the efforts of the nervous system by attacking it in its centres. In such cases of torpid reaction, the patient frequently passes at once into a typhoid state. This is what we call scarlatina maligna, or malignant scarlet-fever.

14. SCARLATINA MILIARIS

Sometimes the red patches of the rash are covered with small vesicles of the size of mustard-seed, which either dry up or discharge a watery liquid, leaving thin white scurfs,