3. It terminated in a pulmonary consumption in a boy of ten years old, with all the symptoms which attend that disease when it follows the regular measles.
4. It affected a child in one family, on the same day that two other members of the same family were affected by the genuine measles.
5. It appeared on the usual days of the genuine measles, from the time the persons affected by it were exposed to its contagion. And,
6. It communicated the disease in one family, in the usual time in which the disease is taken from the genuine measles.
The measles, then, appear to follow the analogy of the small-pox, which affects so superficially as to be taken a second time, and which produce on persons who have had them what are called the nurse pock. They follow likewise the analogy of another disease, viz. the scarlatina anginosa. In the account of the epidemic for 1773, published in the third volume of the Edinburgh Medical Essays, we are told, that such patients as had previously had the scarlet fever without sore throats, took the sore throat, and had no eruption, while those who had previously had the sore throat had a scarlet eruption, but the throat remained free from the distemper. All other persons who were affected had both.
From these facts, I have taken the liberty of calling it the internal measles, to distinguish it from those which are external. I think the discovery of this new state of this disease of some application to practice.
1. It will lead us to be cautious in declaring any disease to be the external measles, in which there is not a general eruption. From my ignorance of this, I have been led to commit several mistakes, which were dishonourable to the profession. I was called, during the prevalence of the measles in the above-named season, to visit a girl of twelve years old, with an eruption on the skin. I called it the measles. The mother told me it was impossible, for that I had in 1783 attended her for the same disease. I suspect the anonymous author before-mentioned has fallen into the same error. He adds to the account before quoted the following words. “Others, who had undergone the measles formerly, had at this time a fever of the erysipelatous kind, with eruptions like to which nettles cause, and all the previous and concomitant symptoms of the measles, from the beginning to the end of the disease.”
2. If inoculation, or any other mode of lessening the violence of the disease, should be adopted, it will be of consequence to know what persons are secure from the attacks of it, and who are still exposed to it.
I shall now add a short account of my method of treating this disease.
Many hundred families came through the disease without the help of a physician. But in many cases it was attended with peculiar danger, and in some with death. I think it was much more fatal than in the years 1773 and 1783, probably owing to the variable weather in the winter, and the coldness and dampness of the succeeding spring. Dr. Huxham says, he once saw the measles attended with peculiar mortality, during a late cold and damp spring in England. It was much more fatal (cæteris paribus) to adults than to young people.