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for the greater number of the fatal cases. Children troubled with a
cough, more or less constant, suffer when attacked by the complaint more
severely than others not so affected. The number of children certified as
dying from Measles is far greater than is popularly supposed. In Southwark,
with a population of 207,000, more than 200 deaths occur from this
disease annually, which number is far larger than that from all the
notifiable infectious diseases put together.
When Measles breaks out in a family, the patient must be put to
bed in the largest room procurable, and as far away from the rest of the
family as possible. It is highly infectious, even in its very early stages,
before the rash appears.
The disease is spread from person to person, and by infected bedding,
clothes, books, and toys.
Symptoms.—Measles generally commences abruptly with lassitude and
chilliness. The patient is sleepy and peevish with loss of
appetite and thirst. From the very commencement of the disease
there is a loud brazen cough and sneezing, with a watery
discharge from the inflamed eyes, nose, and mouth. The voice
is hoarse, and the breathing quick. Usually on the fourth day
from the beginning of the illness, a deep red rash appears on the
face, which afterwards spreads over the body. The face is
swollen and blotchy in appearance. The patient is restless and
irritable. At the end of the second day, the rash begins to fade
from the face, and at the end of the fourth day the whole of the
rash from the body has disappeared, leaving only a mottling of
the skin. The fever at the onset of the disease, and until the
rash has come out, is usually high. The hatching period of the
complaint is about ten days, and the most infective period is the
catarrhal stage, before the rash appears.
Treatment.—The patient must be isolated in a warm room. The mildness
of the complaint will be in proportion to the good ventilation
and size of the room. If the room be small and the
windows closed, a fatal result may be expected, whereas if the
room be large, and there be good ventilation, by the windows
being partly open, assisted by a fire in cold weather, the patient
is almost certain to make a good recovery without any other disease
being left behind.
The patient should be kept in bed for one week after the
rash has disappeared, and should not be allowed to mix with