A text-book of medicine : for students and practitioners / by Adolf Strümpell ; translated by permission from the 2nd and 3rd German editions by Herman F. Vickery and Philip Coombs Knapp ; with editorial notes by Frederick C. Shattuck.
- Date:
- 1887
Licence: Public Domain Mark
Credit: A text-book of medicine : for students and practitioners / by Adolf Strümpell ; translated by permission from the 2nd and 3rd German editions by Herman F. Vickery and Philip Coombs Knapp ; with editorial notes by Frederick C. Shattuck. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
79/1022 page 47
![favored by measles, or that the catarrhal inflammation due to measles leaves behind it an especial predisposition to infection with the tubercular poison. The diagnosis of measles, as of the other acute exanthematous diseases, is based chiefly upon the eruption. Personal experience does more to sharpen the percep- tion than can the fullest descriptions. We can merely suspect the disease during the initial stage unless an epidemic prevails. If, beside the characteristic catarrhal symptoms, the above-mentioned eruption on the mucous membrane of the palate exists, the diagnosis becomes tolerably certain. We should consider that erup- tions similar to that of measles appear in other diseases, more especially in rotheln, scarlet fever, typhus fever, in the beginning of small-pox, and in syphilis. In doubtful cases we shall be enabled to form a decided opinion by the other symp- toms and, above all, by the further course of the disease. Prognosis.—We have already remarked how favorable in general the prognosis is, but we must here repeat that all epidemics do not exhibit the same benign character, and that in every case the physician must bear in mind the possibility of complications, and particularly the danger of severe pulmonary disturbances. Treatment.—The patient should in general be kept somewhat warmer than in scarlet fever. Even in what seem to be the mildest cases the child should be kept in bed till desquamation is over. The sick-chamber is to be somewhat darkened, on account of the photophobia which usually exists at first. In this way normal cases run on favorably without any especial therapeutic interposition. The catarrhal symptoms, however, should always be heeded, since to disregard them may lead to their becoming aggravated. The chief requisite is cleanliness. At regular intervals the eyes, the nasal cavity, and the mouth should be washed out with lukewarm water. If, despite all this, certain disturbances appear in a worse form than usual, or if complications develop, these must receive especial attention. Severe eye troubles should be treated according to the usual ophthalmological practice ; and here unguentum hydrargyri oxidi flavi (1 to 100) [U. S. P. is 40 to 420] and atropine are chiefly employed. The treatment of croupous trouble in the throat or larynx will be fully described in a later chapter. For the pulmonary troubles, lukewarm baths, combined if need be with rather cool douches, constitute the most effectual remedy, which we should employ if it is in any way possible. We thus evoke deeper inspirations and promote expectoration, and thereby contribute largely to preventing the development, or the aggravation, of severe lung trouble. Inhala- tions of steam or of medicated fluids are often advantageously combined with the baths. To substitute the cold pack for the baths is in general justifiable only when the baths are not practicable. The pack is in many respects less efficient than the baths, and is, besides, often less agreeable to the patient. We are not acquainted with any internal remedies for the lung troubles which are at all reliable. In rare instances the excessive accumulation of mucus in the bronchi requires the administration of an emetic. As expectorants we may try ipecac, liquor ammonii anisatus, or benzoin. If considerable intestinal disturbance arises, we must employ small doses of opium, or calomel, or subnitrate of bismuth. We hardly need to say that, whatever else is done, the strength of the patient should be kept up as much as possible by giving wine, broths, milk, eggs, etc. For at least two or three weeks after the disease has ended, the child must be very carefully watched. As the disease is usually so mild, prophylaxis is not very strenuously attempted. If one child in a family is attacked, it is probably already too late to isolate the others, and it is even an advantage to the family to have all the children finish at once what they will hardly be able eventually to avoid. We would make an exception in favor of isolation if the disease prevailed hi a severe form.](https://iiif.wellcomecollection.org/image/b21981565_0079.jp2/full/800%2C/0/default.jpg)
