Advice to the people in general, with regard to their health

by S. A. D. Tissot

§ 222. In some Constitutions the Measles gives Notice of its Approach many Days before its evident Invasion, by a small, frequent and dry Cough, without any other sensible Complaint: though more frequently by a general Uneasiness; by Successions of Shivering and of Heat; by a severe Head-ach in grown Persons; a Heaviness in Children; a considerable Complaint of the Throat; and, by what particularly characterizes this Distemper, an Inflammation and a considerable Heat in the Eyes, attended with a Swelling of the Eye-lids, with a Defluxion of sharp Tears, and so acute a Sensation, or Feeling of the Eyes, that they cannot bear the Light; by very frequent Sneezings, and a Dripping from the Nose of the same Humour with that, which trickles from the Eyes.

The Heat and the Fever increases with Rapidity; the Patient is afflicted with a Cough, a Stuffing, with Anguish, and continual Reachings to vomit; with violent Pains in the Loins; and sometimes with a Looseness, under which Circumstance he is less persecuted with Vomiting. At other times, and in other Subjects, Sweating chiefly prevails, though in less Abundance than in the Small-Pocks. The Tongue is foul and white; the Thirst is often very high; and the Symptoms are generally more violent than in the mild Small-Pocks.

At length, on the fourth or fifth Day, and sometimes about the End of the third, a sudden Eruption appears and in a very great Quantity, especially about the Face; which in a few Hours is covered with Spots, each of which resembles a Flea-bite; many of them soon joining form red Streaks or Suffusions larger or smaller, which inflame the Skin, and produce a very perceivable Swelling of the Face; whence the very Eyes are sometimes closed. Each small Spot or Suffusion is raised a little above the Surface, especially in the Face, where they are manifest both to the Sight and the Touch. In the other Parts of the Body, this Elevation or Rising is scarcely perceivable by any Circumstance, but the Roughness of the Skin.

The Eruption, having first appeared in the Face, is afterwards extended to the Breast, the Back, the Arms, the Thighs and Legs. It generally spreads very plentifully over the Breast and the Back, and sometimes red Suffusions are found upon the Breast, before any Eruption has appeared in the Face.

The Patient is often relieved, as in the Small-Pocks, by plentiful Discharges of Blood from the Nose, which carry off the Complaints of the Head, of the Eyes, and of the Throat.

Whenever this Distemper appears in its mildest Character, almost every Symptom abates after Eruption, as it happens in the Small-Pocks; though, in general, the Change for the better is not as thoroughly perceivable, as it is in the Small-Pocks. It is certain the Reachings and Vomitings cease almost entirely; but the Fever, the Cough, the Head-ach continue; and I have sometimes observed that a bilious Vomiting, a Day or two after the Eruption, proved a more considerable Relief to the Patient than the Eruption had. On the third or fourth Day of the Eruption, the Redness diminishes; the Spots, or very small Pustules, dry up and fall off in very little branny Scales; the Cuticle, or superficial Skin also shrivels off; and is replaced by one succeeding beneath it. On the ninth Day, when the Progress of the Malady has been speedy, and on the eleventh, when it has been very slow, no Trace of the Redness is to be found; and the Surface immediately resumes its usual Appearance.

§ 223. Notwithstanding all which the Patient is not safe, except, during the Course of the Distemper, or immediately after it, he has had some considerable Evacuation; such as the Vomiting I have just mentioned; or a bilious Looseness; or considerable Discharges by Urine; or very plentiful Sweating. For when any of these Evacuations supervene, the Fever vanishes; the Patient resumes his Strength, and perfectly recovers. It happens sometimes too, and even without any of these perceivable Discharges, that insensible Perspiration expels the Relics of the poisonous Cause of this Disease, and the Patient recovers his Health. Yet it occurs too often, that this Venom not having been entirely expelled (or its internal Effects not having been thoroughly effaced) it is repelled upon the Lungs, where it produces a slight Inflammation. In Consequence of this the Oppression, the Cough, the Anguish, and Fever return, and the Patient's Situation becomes very dangerous. This Outrage is frequently less vehement, but it proves tedious and chronical, leaving a very obstinate Cough behind it, with many Resemblances of the Whooping-Cough. In 1758 there was an epidemic State of the Measles here extremely numerous, which affected great Numbers: Almost all who had it, and who were not very carefully and judiciously attended, were seized in Consequence of it with that Cough, which proved very violent and obstinate.

§ 224. However, notwithstanding this be the frequent Progress and Consequence of this Disease, when left entirely to itself, or erroneously treated, and more particularly when treated with a hot Regimen; yet when proper Care was taken to moderate the Fever at the Beginning, to dilute, and to keep up the Evacuations, such unhappy Consequences have been very rare.

§ 225. The proper Method of conducting this Distemper is much the same with that of the Small-Pocks.

1, If the Fever be high, the Pulse hard, the Load and Oppression heavy, and all the Symptoms violent, the Patient must be bled once or twice.