Rubeola. Measles. This disease will be distinguished from the other exanthe. mats, by the dry, hard cough, hoarseness, sneezing, watering of the eyes, coryza, dyspncea, and great drowsiness, or coma. From catarrh, the greater violence of the febrile symptoms, the greater affection of the eyes, and many of the symptoms ac companying the eruptive fever of measles, particularly the coma, will afford a ready diagnosis between the two diseases.
The mosaics indicated in the cure of this disease are, such as will obviate or remove the morbid excitement ; blood letting will therefore be requisite in pro portion to the violence of the fever,cough, and dyspncea, if the nature of the prevail ing epidemic does not contra-indicate ; but as the danger at the commencement of the complaint is for the most part in considerable, that powerful remedy may, unless the excitement is very great, and threatens immediate danger, or much subsequent debility, generally be reserv ed till after the period of desquamation, which is often succeeded by a more den. gerons train of symptoms than any that have preceded; gentle cathartics are in. dispensably requisite in all cases, such as phosphate of soda, Epsom salts, infusion senna, &c.; analogy is, however, greatly in favour of calomel ; tepid mucilaginous diluents should be freely allowed ; it will be advisable to excite a gentle diapho. rests by means of the saline draughts, with small doses of tartarised antimony ; the cough will be alleviated, and expec toration promoted, by a solution of sper maceti, gum arabic, or of the pulvis ;acanthi" compositus, or the decoctum bordei compositum may be employed in considerable quantities; inhaling the va pour of hot water, the application of oil round the chest, and the pediluvium, or warm bath, will be found useful auxi liaries; should the cough and dyspncea prove urgent, attended with pyrexi., or should they remain after the desquama. Lion, blood-letting, either general or local, should be employed : we must, however, be cautious in reducing the strength of the patient; small blisters should be ap. plied in succession aboet the thorax ; the apartment in which the patient continues slmuld be kept cool ; he must not be ex posed to cool air so freely se in the Mill pox, as much disorder may be produced in the system, if, from such exposure, re trocession of the eruption should take place ; the degree of temperature should therefore in a great measure be regulated by the patient's feelings : when the ex citement is subdued by evacuations, and the cough remains the only troublesome symptom, opiates may then be given with great advantage ; and at this period of the disease, a change of air will be of the most essential service. As a morbid ten
dency remains for some time after this complaint, it will be not only advisable, but indispensably necessary, to adminis ter gentle cathartics at proper intervals. If symptoms of pneumonia should super vene after the desquamation, blood-let ting, both general and local,if the strength of the patient will admit of it, blisters, and the other remedies which are mentioned. when treating of that inflammation, must be diligently employed : when a diarrhea remains troublesome, after the desqua mation has taken place, it must not be checked too hastily by the employment of astringents and opiates, on account of the tendency to inflammatory complaints which remains after the measles : the cas carilla or columbo may, however, be em ployed in small doses, before we have re course to more powerful astringents I blood-letting will generally remove both the diarrhea and cough ; it will, there fore, be advisable to endavour to check the diarrhoea by that evacuation, rather than employ astringents in the first in stance. The putrid measles appeared in London in 1672, 1763, and 1768, and have appeared occasionally since : in this variety all the symptoms are more vio lent, accompanied with greater depres sion of strength ; the remedies must be of the same kind, but more actively and instantaneously employed.
. Scarlatina. The general nature and treatment of this discrete will be found in and Cranche Mane°. Oda,. St. Anthony's Fire. This, will readily distinguished from the scarlatina cynanchica, by the absence of the pain, redness, tumour, and sloughs in the faeces and tonsils, and by the other concomitant symptoms. The danger will be in proportion to the violence of the symptoms denoting • tendency to an af fection of the brain; the parts which were red becoming suddenly pale, and a consi. derable degree of coma or delirium, par ticularly at the commencement of the dis ease, with an increase rather than dimi. nudes) of it, after the appearance of the eruption, are symptoms of the utmost danger. When the disease terminates in a favourable manner, there is some times a gentle diaphoresis ; more fre quently, however, the disease goes off without any evident crisis.