576 



ACUTE INFECTIOUS DISEASES. 



gen during the epidemic described by Dr. Pfeikticker, 185 were takec 

 sick ; or, only eleven out of the entire number escaped. Hence, it ap- 

 pears that in isolated places, which are rarely visited by measles, chil- 

 dren are not more liable to the disease than grown persons are. The 

 above-mentioned epidemic in the Faroes, described by Panum, was 

 the first that had occurred for sixty-five years in that isolated island ; 

 hence almost all the inhabitants under sixty-five years of age, who had 

 not had the measles somewhere else, were attacked by the disease, 

 whether they were young or old. Children under six months often 

 escape during an epidemic of this disease. In the above-mentioned 

 epidemic, not a child under five months was attacked ; while, above 

 six months, almost all were. Very old persons also rarely have the 

 disease. Acute and chronic maladies, pregnancy, and the puerperal 

 state, do not protect from measles ; but, as was above said, the dis- 

 order not unfrequently makes its appearance at the end of an acute 

 disease, during which the infection has occurred. Measles occurs in 

 more or less extensive epidemics ; the extent of the epidemic depends 

 chiefly on the length of the interval that has elapsed since the last one, 

 and consequently on the number of persons who have not yet been at- 

 tacked. The epidemic at the Faroes furnishes an excellent example 

 of this also. But the state of the weather appears to have a great in- 

 fluence on the extent of epidemics, for the greatest number and the 

 largest epidemics occur in the winter and autumn, or in cold, damp 

 summers. Great extent of the disease generally corresponds with 

 great severity of the individual cases, and the most malignant cases 

 usually occur at the height of the epidemic. 



ANATOMICAL APPEARANCES. The normal exanthema of measles 

 disappears after death, and only the haemorrhages in the tissue of the 

 cutis, which sometimes occur, are discoverable in the dead body. The 

 anatomical changes observed during life on the skin of a measles pa- 

 tient consist in an eruption of numerous roundish red spots about the 

 size of a millet-seed, somewhat elevated, and generally having a small 

 papule at the middle. In some places several spots unite, forming 

 irregular semilunar patches ; at other places the spots are isolated. 

 Between the spots the skin retains its normal color ; in the face, it is 

 usually somewhat cedematous. According to 6r. Simon, the papules 

 on the measles eruption, although chiefly located at the point where 

 the hairs escape from the skin, are not swellings of the hair-follicles or 

 sebaceous glands, but consist of small collections of inflammatory exu- 

 dation at circumscribed points in the skin. Occasionally the eruption 

 shows an unusual tendency to confluence (morbilli confluentes) ; even 

 in such cases, however, the diffuse redness is not regular, but main- 

 tains an irregularly spotted appearance. In most of the spots which 



