MEASLES. 579 



height as the exanthema reaches its full extent. The stadium flores- 

 centice cannot be distinctly distinguished from the eruptive stage, for 

 hi most cases the exanthema is just at its height as the eruption is 

 completed, and it generally begins to disappear in twenty- four hours. 

 The fever, also, which usually attains its height at the completion of 

 the eruption, rapidly moderates, and sometimes disappears in the sta- 

 dium florescentiae, so that the parents have great difficulty to keep in 

 bed the little patients, who are often still covered with red spots, but 

 are already full of spirits. The catarrhal symptoms continue, it is true, 

 but they are much milder ; the photophobia is less, the secretion from 

 the nose is more scanty and thick, sneezing is rarer, the voice less 

 rough, the cough looser, and older children, who do not swallow the 

 sputa, cough up more or less muco-purulent masses (sputa cocta). On 

 the third or fourth day after their occurrence, the spots, especially those 

 of the first crop, are ordinarily much paler, or have entirely disappeared, 

 commonly leaving a bright-yellow discoloration on the skin for a time. 



In favorable cases, the fourth stage, stadium desquamationis, usu- 

 ally succeeds the stadium florescentia the eighth or ninth day of the 

 disease. At this time the spots have entirely disappeared, and their 

 former seat is covered by a bran-like desquamation of the epidermis. 

 If the detached epidermic scales be softened, and macerated by con- 

 stant perspiration, the desquamation is not so evident as if the skin be 

 dry ; hence, it is less perceptible on the parts covered by the bed- 

 clothes than on the face, neck, and hands. In the desquamative stage, 

 the fever has almost always disappeared. The catarrh also passes off 

 gradually, and about the fourteenth day of the disease, or somewhat 

 later, as the desquamation ends, the measles terminates. 



In many cases the disease runs its course without much deviation 

 from the description above given. These cases, where there is no 

 material deviation from the " normal " course, and where the different 

 stages are not accompanied by any peculiar symptoms, are usually 

 called morbilli vulgares, simpttces, or erethici. 



In other cases, usually called inflammatory or synochal measles, 

 the exanthema appears with very violent symptoms ; the spots, which 

 are usually close together, and often confluent, do not begin to lose 

 color in twenty-four hours, but at this time grow darker, and remain 

 visible on the skin for five or six days. Occasionally the exanthema 

 assumes a violet or bluish color, and does not disappear under the 

 pressure of the finger ; this depends on partial rupture of the over- 

 filled capillaries, and may be regarded as analogous to the haemor- 

 rhages occurring in the inflammatory disturbances of nutrition. The 

 correctness of this view is supported by the fact that this form of 

 hacmorrhagic measles usually runs a favorable course, and is not at aP 



