MKASLKS. 27 



swollen up and intolerant of light, its throat too sore to swallow, its nose tender and 

 discharging, almost deaf from the spreading of the trouble from the throat and face to 

 the ears, and harassed by incessant coughing and sneezing. 



When measles runs an uncomplicated course, it is not a disease which generally 

 califs much alarm. When measles is fatal, it is so by its complications ; and it is 

 for these complications which the friends and the doctor should ever be on the look- 

 out, and for the prevention of which much of the treatment is directed. 



These complications often occur in the windpipe or lungs. We may have inflam- 

 mation of the windpipe established, or inflammation of the lung-tubes (bronchitis), 

 or inflammation of the lung substance itself (pneumonia). These complications are 

 all serious, and are indicated by noisy breathing, great increase of cough, very rapid 

 respiration, and sometimes by signs of impeded respiration and commencing suffoca- 

 tion. When any of these complications occur, the child cannot be considered to be 

 free from danger. 



Complications referable to the bowels are not uncommon, and obstinate diarrhoea 

 often proves a great trouble. It should be considered a rule that dining measles all 

 purgative medicine should be given with a most sparing hand, lest by setting up 

 diarrhoea the life of the patient be jeopardised. Measles is liable to be confounded 

 with certain other diseases, or other diseases which resemble measles may be mis- 

 taken for it. Children are not unfrequently troubled with a rash closely resembling 

 measles, which is called roseola, but which differs from measles (1) in coming out 

 all over the body at once ; (2) by not running a definite course ; (3) in not being 

 accompanied by the running at the eyes and nose which are characteristic of measles ; 

 and (4) by often being directly attributable to some error in diet. 



Smallpox and scarlet fever have both been mistaken for measles an. error which 

 may be fraught with serious consequences. The mode of outset of small pox is more 

 severe than that of measles, and the eruption differs in several ways : thus, the 

 small-pox eruption begins in the centre of the face, while that of measles is at the 

 roots of the hair; the small-pox eruption is raised and hard and soon becomes 

 mattery (pustular), while that of measles is scarcely perceptibly raised, and never 

 suppurates. The commencement of scarlet fever is usually marked by the severity of 

 the throat symptoms, while in measles these are generally of a subordinate character. 

 The eruption of scarlet fever is a bright scarlet, composed of fine dots, and commences 

 at the root of the neck and top of the chest. 



When the disease has subsided, and convalescence sets in, the child requires the 

 greatest care, for patients who are recovering from any febrile disorder, but more 

 especially measles, are very prone to fall into constitutional weaknesses, which may 

 prove rapidly fatal, or cause a " delicacy " of constitution which may last for a life- 

 time. Tuberculosis in one of its forms may be, and veiy often is, established; and 

 it is 110 unusual thing to see a child become consumptive, or succumb to meningitis, 

 or tuberculosis of the intestines (marasmus). Discharges from the ear, which 

 are often very troublesome and difficult to cure, are not unfrequently caused by 

 measles. Gangrene of the cheek is a somewhat rare occurrence, and happily so, for 

 Nvlu'u it happens it is almost invariably fatal. During convalescence from measles, 

 children are peculiarly liable to contract whooping cough, and, strangely enough, the 



