Recurrent roseola shows a tendency to appear along the posterior intercostal spaces, never appearing on the anterior surface of the thorax or abdomen. This has been seen in syphilis. As the erup tion is fleeting. all syphilitics were ex amined twice weekly. Only eight typical cases were found among 1089 patients. Other varieties of roseola occurred, both eircinate and ovoid. This eruption ap peared in distinct lines along the inter costal spaces, each spot. discrete, the whole resembling the branches of a tree, of which the spine was the trunk. The upper brandies were shorter than those lower down. The eruption was visible from one to two weeks, being very dis tinct only a few days. De Beurmann and Louis Detherm (Jour. des Praticiens,. April 13, 1901).
Etiology.—Analogy leads to the belief that rubella is caused by a specific micro organism, but the germ has not yet been discovered. It is contagious, though not as strongly so as scarlet fever and measles. Its contagious power at times seems to be very slight. It is most contagious when the eruption is at its height. It is rarely, if ever, seen under six months,. but after that age no period of life is exempt. It is most common between five and ten years. The recurrence of true rubella is rare. The disease
occurs in epidemics, which are most com mon in the spring.
Complications and Seguelm.—No other infectious disease is so free from com plications. This is, in fact, one of the• most marked peculiarities of rubella. Even varicella sometimes shows a serious complication: that of gangrene. No such serious symptom is likely to arise in rubella. The pneumonia, otitis, erysipe las, and multiple abscesses, which in rare instances have been reported as accom panying rubella, are perhaps not in every case a complication, but rather a coin cidence.
Prognosis.—Death from rubella is ex tremely infrequent. In the rare cases in which it occurs it is usually the re sult of some pulmonary disease, occur ring either as a complication or as a co– incidence.
Treatment.—Rubella requires very lit tle, if any, treatment. Mild treatment appropriate to any febrile condition is permissible, but if the patient is kept in bed while the fever and rash continue, and is anointed daily with oil, further treatment will rarely be required. Symp toms must be treated as they arise. In most cases the disease as such is of but little importance, its chief interest lying in its diagnosis, owing to its resemblance to two more serious diseases.