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.
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![[It is not customary with, us to insist so strongly upon isolation and thorough disinfection as in scarlet lever. But the tendency of the present day is toward a wide application of the principles of preventive medicine. It is certainly of no advantage to a child to contract the measles. Delicate children, especially those with tubercular predisposition, should be carefully guarded against it ; and, even if it is decided that it is not worth while to attempt to confine the disease to one member of a family, every precaution should be taken against infecting other families. Under suspicious circumstances, consequently, children are to be kept away from school and from contact with others. The liability to scrofulous and tubercular affections after recovery from the disease is to be borne in mhid, and often demands in mothers special attention to general hygiene in order that full vigor may he regained.] CHAPTER VI. ROTHELN. ( German Measles.) Rotheln is a disease similar to measles, but distinct from it, although formerly often confounded with it, and perhaps with scarlet fever as well. The observations of Steiner, Thomas, and others leave now no room to doubt that these diseases are distinct, for epidemics occur in which all cases present the characteristic peculiari- ties ascribed to rotheln. But the best proof is that children who have had rotheln are not infrequently attacked by genuine measles later. It may indeed he very difficult in an individual case to decide which disease is present ; but that rotheln does exist, as an independent form of disease, can be denied by those alone who have never seen it. After an incubation of about two or three weeks the disease begins with the appearance of the eruption. Initial symptoms pi’eceding the eruption are either wholly absent or at most last for half a day. The eruption is decidedly like that of measles, hut its individual spots are smaller. They are seldom larger than small peas and circular, being only exceptionally as dentated and irregular in outline as are the maculae of measles. They appear on the whole face, the head, the trunk, and the extremities, are pale red, hut slightly elevated, and are not apt to become confluent. The soft palate sometimes exhibits, as in measles, a faint macular eruption at the beginning of the disease. After two to four days the eruption fades. There is usually no decided desquamation. Other symptoms of disease than this eruption are slight. Fever in many cases appears to be entirely absent. As a rule, there is for a day or two a slight eleva- tion of temperature, reaching 102° (39° C.) at most. Tokens of a moderate catarrh of the conjunctiva, the nasal mucous membrane, the throat, and the larynx are also observed—viz., photophobia, nasal discharge, and cough. Sometimes the cervical lymph-glands are a little swollen. The constitutional disturbance is generally so slight that the child can hardly he kept in bed. Important complica- tions hardly ever occur. The prognosis of rotheln is therefore perfectly favorable, and the employment of any special treatment is needless.](https://iiif.wellcomecollection.org/image/b21981565_0080.jp2/full/800%2C/0/default.jpg)
