DESQUAMATION. — Desquamation be gins as soon as the eruption has faded, and follows the order of its appearance. It rarely continues more than ten days in any given area, and may be of much shorter duration. It is most intense where the eruption has been most in tense. It occurs in fine branny scales quite unlike the lamellar desquamation of scarlet fever. It is often so slight as to be completely overlooked, particularly when inunctions of the skin have been carefully used. Desquamation is usually completed in from twenty to twenty-four clays after the onset of the disease.
Irregular Forms.—Measles is capable of assuming very irregular and atypical forms. Such irregular types are most common in children under three years. Nevertheless, in a given number of cases a much larger proportion of measles cases will run a typical or regular course than will a similar number of cases of scarlet fever.
In an epidemic of 423 cases. only 123 were of the regular type; 103 were of the malignant type, complieated with some other disease, and furnished 7 of the fatal cases. The remaining 200 cases were of the bremorrhagic form. The only symptoms present in absolutely all the eases, of whatever type, were rise of temperatnre and eruption. The catar rhal symptoms were entirely absent in about 5 per cent. of the cases. The mouth-rashes of Guersant and Blache and of Girard were present in only about 25 per cent. C. J. Edgar (Canada Med. Record, Dec., '92).
—The disease may be ex tremely mild, the eruption being faint,. the fever slight, and all the symptoms mild. Such cases present no variation from the usual type except that of mild ness in degree. Although the catarrhal symptoms may be slight, the diagnosis of morbilli sine catarrh, should be made with extreme hesitation.
Case of atypical measles in which there was sudden onset, absence of coryza, ery thematous sore throat, and scarlatiniform eruption. J. C. Wilson (Med. and Surg. Reporter, Jan. 17, '91).
Case of measles in which all catarrhal symptoms Nvere absent. J. B. Harris
(Lancet, Feb. 21, '91).
Case of a girl who had measles for the first time at eight years, and a second attack two years later.
In the first attack the skin was se verely affected, but the catarrhal symp toms were extremely mild. In the sec ond attack the throat symptoms were severe and characteristic, but the exan- them did not appear until two or per haps three days after the usual time, as indicated by the other symptoms, was imperfectly developed, and soon faded. Gottstein (Aliinch. med. .No. 13, '96).
During, last winter and spring very severe epidemics of pertussis and mea sles were witnessed, in White County, Tenn. The whooping-cough made its ap pearance a few weeks previous to trie outbreak of measles. Four aggravated cases of pertussis contracted measles, and not one of the four had a symptom of pertussis after the measles eruption was well developed, and all made an un evvutful recovery from both diseases. The children (aged from two to four years) had from fifteen to twenty par oxysms per day. Two of the cases had hremorrhages from the mouth with al most every paroxysm. H. B. Young; (Med. News, Afar. 2, 1901).
••.., 1..0 pa . • - It I a I ? II t ho • tip', Term. 1;1 t hese, I ..• ; I e earlier in the c., diphtheria de ..,. ion, t he prog • f e iliplith,•ria or ; ? of it, oi ,et should be •-; ;; a,e of mea.sles. ...1. f the mucous membrane . ss uaused h.\ measles -0, iertile for t lie .•. t ; e diphtheria organism. I).
an I. F. Burrom s (130ston V... July 25, 1901).
T11.E.- A severe form is L. tr scin, marked by unusually tLini.iraturc, intense eruption, and t 1 all thc symptoms. Except in •ruldr(n. the uncomplicated dis •.„,L, l‘t.11 Whin of severe type, is rarely r,t.t it should not be forgotten Lid/ a ttn.pirature that reaches an un liy hid. point or continues unabated a- 110. eruption fades is usuallv due to .nplication. commonly pulmo n Irv. Anv marked variation from the 1,...11 type demands particular attention, fpr ininonly indicates a complication.