A text-book of medicine for students and practitioners / by Adolf Strümpell ; With editorial notes by Frederick C. Shattuck.
- Adolph Strümpell
- Date:
- 1901
Licence: Public Domain Mark
Credit: A text-book of medicine for students and practitioners / by Adolf Strümpell ; With editorial notes by Frederick C. Shattuck. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![As the disease is usually so raild, prophylaxis is not very strenuously at- tempted. 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 chil- dren 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 in a severe form. [It is not customary with us to insist so strongly upon isolation and thorough disinfection as in scarlet fever, 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 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. If there is any reason to fear the development of tuberculosis, every possible hygienic means should be employed in order that full vigor may be regained.] CHAPTER VI ROTHELIT {German Measles) EoTHELN is a disease similar to measles, but distinct from it, although formerly often confounded with it, and perhaps with scarlet fever as well. The observa- tions of Steiner, Thomas, and others leave now no room to doubt that these dis- eases are distinct, for epidemics occur in which all cases present the characteristic peculiarities ascribed to rotheln. But the best proof is that children who have had rotheln are not infrequently attacked by genuine measles later. It may in- deed be 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, which is usually noticed first in the face. Initial symptoms (cough, sneezing, etc.), preceding the eruption, either are wholly absent or at most last for half a day. The eruption is decidedly like that of measles, but 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 (sometimes deep red), only slightly elevated, and are not apt to become confluent. In rare instances, small vesicles develop upon the macules. 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 desquama- tion. 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 little elevation 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. Often, the cervical lymph-glands are more or less swollen. The constitutional disturb-](https://iiif.wellcomecollection.org/image/b21206296_0081.jp2/full/800%2C/0/default.jpg)
