Very shortly, an increased secretion of the mucus of these parts
occurs, and, collecting about the tonsils, aggravates the child's
sufferings, from the frequent and ineffectual efforts made to expel it.
If the inflammatory action be more severe, exudations of lymph will
also be poured out, and intermingling with the mucus, greatly augment
the difficulty of swallowing. At this time the lining membrane of the
mouth, as also the tongue, assume a florid red colour; the red points
of the latter becoming much elongated.
The febrile symptoms are severe from the first; amongst others, there
will be headach, sometimes accompanied by slight delirium, nausea,
intense heat of skin, languor, and considerable inquietude and anxiety:
and as the inflammation approaches its height, the fever increases, the
pulse rises, the breathing becomes oppressed, the skin becomes more
pungently hot and dry, and the thirst urgent. All these symptoms being
increased towards evening, when the febrile restlessness is often
succeeded by delirium.
The rash is seldom perceptible before the third day, and then comes
out in irregular patches on various parts of the body, particularly
about the elbows and wrists; thus differing as to the time and mode of
its appearance, from the mild form of the disease.
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