336 THE DISEASES AND DISORDERS OF THE OX. 



Acceleration of the pulse, especially in children, is a notable 

 feature of the disease. On the first day it probably rises to 

 between 100 and 120, and in children still higher. It generally 

 continues to increase up to the time of full development of the 

 rash, sometimes attaining a rate of 160 or more, after which, 

 if the case go on favourably, it somewhat rapidly falls. Unusual 

 rapidity of pulse, together with marked weakness, is of grave 

 import. 



Kespiration is always at first more or less hurried, i.e. in all 

 but the mildest cases ; but there is not necessarily any cough or 

 diflBculty of breathing. If the case is a very bad one, the 

 respirations become very rapid and shallow, and the inspirations 

 are attended with dilatation of the nostrils, and a snifi&ng or 

 sucking sound. These conditions, unattended with distinct 

 pulmonary lesion, indicate very great danger. During the latter 

 part of the eruptive stage or subsequent periods of the disease, 

 inflammation may extend to the larynx and trachea, and produce 

 the usual symptoms of laryngitis ; or coryza, bronchitis, or 

 lobular or lobar pneumonia, with their several groups of 

 symptoms, may come on. Coryza may occur at a very early 

 stage. 



Thirst and loss of appetite are always present in a greater or 

 less degree during the pyrexial state. Vomiting is a charac- 

 teristic feature of the invasion, and there are but few children 

 who do not suffer from it; but it does not persist as a rule. At 

 the beginning diarrhoea may occur, and afterwards the bowels 

 are generally, but by no means always constipated. The tongue 

 varies in character. In very mild cases it is only slightly furred, 

 and soon cleans, without ever displaying the strawberry-like 

 appearance. Sometimes it very early becomes thickly coated, 

 dry, and even black, sordes appearing at the same time on the 

 teeth and lips. More usually it is coated at the first, and on 

 the fourth or fifth day it becomes clean and unnaturally red 

 with prominent and swollen papillae, after which it may either 

 gradually acquire the normal characters or become dry and 

 mahogany-like. The soreness of the throat causes difficulty and 

 pain in swallowing, and a nasal quality of voice. The soreness 

 involves all the parts at the back of the mouth, the fauces, and 

 the upper part of the pharynx; but it does not, as a rule, 

 include the larynx. The tonsils chiefly suff'er, and, as has been 



