There are several varieties of this disease; it will be more perspicuous, however, for our purpose to speak of it under the two following forms:—­

Mild scarlet fever;

Scarlet fever, with sore throat.

Mild scarlet fever.—­In this form of the disease there is only the rash with fever.

Symptoms.—­The anticipating symptoms are those of fever:  they precede the eruption.  The degree of fever, however, is variable; for the symptoms are sometimes so moderate as scarcely to attract attention, slight and irregular shivering, nausea, perhaps vomiting, thirst, and heat of skin; whilst, at others, there is considerable constitutional disturbance, indicated by pungent heat of skin, flushing of the face, suffusion of the eyes, pain in the head, great anxiety and restlessness, and occasionally slight delirium.

These symptoms are followed on the second day (in the majority of instances) by the rash.  This first appears in numerous specks or minute patches of a vivid red colour on the face, neck, and chest.  In about four-and-twenty hours it becomes gradually diffused over the whole trunk.  On the following day (the third) it extends to the upper and lower extremities, so that at this period the whole surface of the body is of a bright red colour, hot and dry.  The efflorescence, too, is not always confined to the skin, but occasionally tinges the inside of the lips, cheeks, palate, throat, nostrils, and even the internal surface of the eyelids.  Sometimes the efflorescence is continuous and universal; but more generally on the trunk of the body there are intervals of a natural hue between the patches, with papulous dots scattered over them, the colour being most deep on the loins and neighbouring parts, at the flexure of the joints, and upon those parts of the body which are subjected to pressure.  It is also generally most vivid in the evening, gradually becoming paler towards morning.

The eruption is at its height on the fourth day;—­it begins to decline on the fifth, when the interstices widen, and the florid hue fades;—­on the sixth, the rash is very indistinct; and on the eighth day it is wholly gone.

The various symptoms with which the eruption is accompanied, gradually disappear with the efflorescence; but the tongue still remains morbidly red and clean.  The peeling off of the cuticle (the outer layer of the skin), which begins about the end of the fifth day on the parts on which the eruption first appeared, proceeds; so that about the eighth or ninth, portions of the cuticle are thrown off, the thickest and largest being those detached from the skin of the hands and feet.

Scarlet fever, with sore throat.—­In this form of the disease, the fever and rash are accompanied with inflammation of the throat.

Symptoms.—­The symptoms are more severe than in the mild form of this disease, and, in the majority of instances, the inflammation of the throat appears with the eruption, and goes through its progress of increase and decline with the cutaneous eruption.  Sometimes, however, it precedes the fever; whilst at others it does not appear until the rash is at its height.