Measles. This is a contagious, febrile disorder. It is nearly always more or less prevalent in this country, but at times it spreads with great rapidity and causes many deaths. As a rule, children and young people are attacked, but the exemption of adults and older people is probably due to the fact that most of them have had the disease in childhood. Sometimes people have a second attack. Symptoms. — Before the appearance of the rash there are some precursory symptoms; the patient feels languid and hot, there is shivering, followed by a rise of temperature, a quick pulse, thirst, loss of appetite and sickness. The eyes become red and watery, and give the patient the appearance of having cried; the membrane which lines the nose, throat, larynx and trachea is red and swollen, and pours forth a watery secretion ; thus the affected person appears to have a severe cold, with running from the eyes and nose; hence there is 334 Diseases of Infancy and Childhood generally much sneezing, with a slightly sore throat and a dry, harsh cough. Convulsions occasionally occur in children. After these symptoms have lasted three or four days the rash appears. It begins in very small papules or minute pimples which rapidly multiply, and these run together into patches which have a tendency to a horseshoe, or crescent shape, while the portions of skin between are of a natural color. Commencing on the face and neck, it spreads to the arms, then the trunk of the body and gradually reaches the lower extremities. When the eruption has disappeared the part of the skin affected becomes covered with a dry scurf. Complications are liable to occur. Convulsions at the com- mencement are usually without danger; if they come on at the end of the disease they may lead to a fatal issue. In- flammation of the lungs is very common in measles, and bronchitis, which may prove fatal to young children, adds to the danger. Treatjnent. — The child must be kept in bed. The room should be airy and well ventilated, but the patient must not be exposed to draughts. All offensive excreta and dirty linen should be removed and disinfected. A fire should be kept burning and the temperature should be about 60° or 65" Fahrenheit. The blinds should be kept down on account of the patient's eyes, and he should lie with his back to the light. In all cases it is advisable to give the patient a hot bath at the very onset of the disease ; then dry the surface of the body and put the child to bed directly. All sources of annoyance and irritation and all noises should be avoided. Food of the simplest nature should be given. Milk, milk and water, chicken broth, beef tea and toast and water may be given. When the fever subsides a small piece of chicken or fried sole may be given, toast or bread and butter, with a fresh egg may also be given, and, as the tongue cleans and the appetite returns, the patient may be allowed to resume Diseases of Infancy and Childhood 335

AI-modernized reading of the original text

Measles. This is a contagious, febrile disorder. It is nearly always more or less prevalent in this country, but at times it spreads with great rapidity and causes many deaths. As a rule, children and young people are attacked, but the exemption of adults and older people is probably due to the fact that most of them have had the disease in childhood. Sometimes people have a second attack. Symptoms. — Before the appearance of the rash there are some precursory symptoms; the patient feels languid and hot, there is shivering, followed by a rise of temperature, a quick pulse, thirst, loss of appetite and sickness. The eyes become red and watery, and give the patient the appearance of having cried; the membrane which lines the nose, throat, larynx and trachea is red and swollen, and pours forth a watery secretion ; thus the affected person appears to have a severe cold, with running from the eyes and nose; hence there is 334 Diseases of Infancy and Childhood generally much sneezing, with a slightly sore throat and a dry, harsh cough. Convulsions occasionally occur in children. After these symptoms have lasted three or four days the rash appears. It begins in very small papules or minute pimples which rapidly multiply, and these run together into patches which have a tendency to a horseshoe, or crescent shape, while the portions of skin between are of a natural color. Commencing on the face and neck, it spreads to the arms, then the trunk of the body and gradually reaches the lower extremities. When the eruption has disappeared the part of the skin affected becomes covered with a dry scurf. Complications are liable to occur. Convulsions at the commencement are usually without danger; if they come on at the end of the disease they may lead to a fatal issue. Inflammation of the lungs is very common in measles, and bronchitis, which may prove fatal to young children, adds to the danger. Treatment. — The child must be kept in bed. The room should be airy and well ventilated, but the patient must not be exposed to draughts. All offensive excreta and dirty linen should be removed and disinfected. A fire should be kept burning and the temperature should be about 60° or 65" Fahrenheit. The blinds should be kept down on account of the patient's eyes, and he should lie with his back to the light. In all cases it is advisable to give the patient a hot bath at the very onset of the disease ; then dry the surface of the body and put the child to bed directly. All sources of annoyance and irritation and all noises should be avoided. Food of the simplest nature should be given. Milk, milk and water, chicken broth, beef tea and toast and water may be given. When the fever subsides a small piece of chicken or fried sole may be given, toast or bread and butter, with a fresh egg may also be given, and, as the tongue cleans and the appetite returns, the patient may be allowed to resume Diseases of Infancy and Childhood 335

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