The measles appeared first in the Northern Liberties, in December. They spread slowly in January, and were not universal in the city till February and March.
This disease, like many others, had its precursor. It was either a gum-boil, or a sore on the tongue. They were both very common, but not universal. They occurred, in some instances, several days before the fever, but in general they made their appearance during the eruptive fever, and were a sure mark of the approaching eruption of the measles. I was first led to observe this fact, from having read Dr. Quin's accurate account of the measles in Jamaica. I shall now proceed to mention the symptoms of the measles as they appeared in the different parts of the body.
1. In the head, they produced great pain, swelling of the eye-lids, so as to obstruct the eye-sight, tooth-ach, bleeding at the nose, tinnitus aurium, and deafness; also coma for two days, and convulsions. I saw the last symptom only in one instance. It was brought on by a stoppage of a running from the ear.
2. In the throat and lungs, they produced a soreness and hoarseness, acute or dull pains in the breast and sides, and a painful or distressing cough. In one case, this cough continued for two hours without any intermission, attended by copious expectoration. In two cases, I saw a constant involuntary discharge of phlegm and mucus from the mouth, without any cough. One of them terminated fatally. Spitting of blood occurred in several instances. The symptoms of pneumonia vera notha and typhoides were very common. I saw two fatal cases from pneumonia notha, in both of which the patients died with the trunk of the body in an erect posture. I met with two cases in which there was no cough till the eruption made its appearance on the fourth day, and one which was accompanied by all the usual symptoms of the cynanche trachealis.
3. In the stomach the measles produced, in many instances, sickness and vomiting. And
4. In the bowels, griping, diarrhœa, and, in some instances, bloody stools. The diarrhœa occurred in every stage of the disease, but it was bloody and most painful in its decline. I attended a black girl who discharged a great many worms, but without the least relief of any of her symptoms.
There was a great variety in this disease. 1. In the time of the attack of the fever, from the time of the reception of the contagion. In general the interval was fourteen days, but it frequently appeared before, and sometimes later than that period.
2. In the time of the eruption, from the beginning of the fever. It generally appeared on the third and fourth days. In one case, Dr. Waters informed me, it did not appear till the eighth day.
3. In the abatement or continuance of the fever after the eruption.