MEASLES.—Measles is an acute infectious disease, distinguished by a characteristic eruption on the mucous membranes and skin. It is very contagious and spreads through the atmosphere. Almost everyone is susceptible to measles and suffers at least one attack. The disease is not frequent during the first year of life. It prevails in all countries.
Incubation.—This varies from thirteen to fifteen days. In calculating this period we include the time from exposure to the appearance of the eruption. One attack generally protects the person from another attack. The period of the greatest danger of taking it extends through the period of the eruption. It diminishes as the eruption fades. From this we learn that the infection in measles takes place generally in the incubation stage.
Symptoms and Description of Ordinary Type.—The first symptoms may be only a headache or a slight disturbance of the stomach. There may be some fever in the evening. There is now a redness and watery condition of the eyes, and general feeling of weariness. The cold symptoms (coryza) are not yet marked, but if we look in the mouth we may see a few spots on the mucous membrane of the cheek. Then follow the sneezing, running at the nose, sore and red eyes; running water, sensitiveness to the light, cough and fever. The eruption now appears, and is first noticed on the side of the head and the wings of the nose, as a red spotted eruption, which soon looks like a pimple, and then "blotchy." Older people feel quite sick. The aching all over, and headache are sometimes almost unbearable, especially when there is much coughing. The face, eyes and scalp are soon covered by the red rose irregularly shaped pimples, which next appear rapidly on the back of the hands, fore-arms, front of the trunk, on the back and lower extremities. This order is not always maintained. Sometimes it first appears on the back.
The eruptive stage generally lasts three or four days, during which time the symptoms are all aggravated, especially by any strong light, on account of the sore eyes for the measles are also in them. We have active cold symptoms like sneezing, running at the nose, snorting, snuffling, hawking. The cough is terribly severe, annoying, making the lungs and stomach very sore. The head feels as if it would split. The patient holds his chest and "stomach" while coughing. Symptoms of acute bronchitis develop. Sometimes there is much diarrhea. Pneumonia often develops through carelessness. The fever reaches its height when the eruption is fully developed. The eruption fades after it has been out for three or four days, and then all the symptoms decrease, the fever lessens and becomes normal by gradual morning remissions. Scaling begins when the pinkish hue of the rash has disappeared and continues until the last vestige of reddish spots has disappeared. As a rule it is completed in two to four weeks after the first eruption has appeared. Sometimes the scaling is difficult to see, but it is never absent in measles: It is best seen on the front part of the chest, shoulders, and the inner surface of the thighs. The temperature may reach 104 to 105-8/10 without complications. This description gives a picture of a typical case. The eruption that appears in the mucous membrane of the mouth appears three to four days before the skin rash. It is accompanied by redness of the pharynx and of the front and back pillars of the fauces. The soft palate is studded with irregular shaped, rose colored spots or streaks and the hard palate presents small whitish vesicles. They are also found on the colored mucous membrane of the cheeks and on that opposite the gums of the upper and lower teeth. The rash of measles is a characteristic eruption of rose colored or purple colored papules (pimples). As a rule the whole face is covered with the eruption and is swollen. Diphtheria may complicate measles. Bronchitis and brancho-pneumonia also may occur, especially if the patient is careless and takes cold. Diarrhea is frequently present.
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Eyes.—Following severe cases fear of light, spasm of the orbicularis muscle, inflammation of the lachrymal duct, conjunctivitis, ulceration of the cornea and amaurosis (general blindness) may result. Hence the necessity of careful attention to the eyes. Never read anything during the attack of the measles. The ear may also become afflicted. There are other complications, but these mentioned are the important ones.
Mortality in Measles.—The mortality in childhood and infancy is about eight per cent. Mortality is greatest for number of cases during the first year. Six per cent between fifth and eighth years.
Diagnosis.—Presents few difficulties in a typical case. The mode of onset is cold symptoms of the nose and eye, cough; appearance of the mouth, throat and the blotchy eruptions are very characteristic.
Treatment. Prevention.—As soon as you know it to be the measles, separate the case and put the patient in a well-aired room where you can have air without a draft and where the room can be made and kept dark. Those persons who must go in the room should put over them a linen robe, and hang it outside of the sick room. It should thoroughly cover them. When not in use hang it in the open air. An attendant who wears a beard should disinfect his beard, face, head and hands before mingling with the well.
MOTHERS' REMEDIES.—1. Measles, Lemon Remedy from a Canadian Mother.—"Give child all cold lemonade it can drink and keep in warm room. This acts just as well as if the drinks are hot. We tried both on our children and cured both ways." Don't give so much of the cold as to chill. The cold drink makes child sweat, just as hot does. Also helps to carry off impurities by flushing bowels, just as clear water would.