MEASLES.
The general hygiene, nursing and feeding are practically identical with those indicated in, the management of the other exanthematous fevers— scarlatina, rotheln, typhoid, typhus and variola.
Prophylaxis is of vital importance; the infectiousness of the disease is intense before the rash appears, hence the importance of the recognition of measles at the earliest possible period. The diagnosis will be helped by the presence of Koplik's spots on the buccal membrane, and these must be always sought for. Rigid isolation should be carried out at the earliest moment.
No convalescent patient should be permitted to mix with the healthy till a period of 21 days.
As soon as the attack declares itself the child should be put to bed. A wire spring-mattress, upon the top of which a thin, hard hair-mattress is placed, and a moderate amount of bedclothes should be provided. The temperature of the sick-room should not be allowed to exceed F. Certainly, in the absence of special reasons, such as laryngeal complica tions, the atmospheric temperature should not exceed F. Thorough ventilation should be secured, and a continuous supply of pure warm air is essential. Owing to the irritability of the respiratory mucosa it will generally be found necessary to have some arrangements for moistening the air; the ordinary bronchitis kettle answers all requirements. Where the physician has the choice of rooms for the treatment of any of the exanthemata, he should select a large, airy apartment, with an open grate, and, when possible, with a ventilator opening into a flue. The bed can be surrounded by a couple of screens in a large room; this will enable the most thorough ventilation to be carried out without subjecting the patient to draughts of cold air. It is very desirable to have two beds in the sick room, one for the day and the other for the night, and, when possible, it is an even better plan to have one bed for the night in an adjoining room which communicates directly by a door with the day-room. When two children are to be treated, they should each have a separate bed, and the ventilation of the room must he most thorough.
In a case of measles it is customary to have the light subdued by partially drawing the blinds, but the complete darkness so often insisted upon is unnecessary, and the patient's own feelings may be taken as a guide in this matter. Bright sunlight should, when possible, be admitted into the room and be allowed to flood every part of its atmosphere save that in the immediate neighbourhood of the patient's eyes, which may be shaded by a curtain, screen or by the drapery of the bed; but the fewer bed hangings the better.
Every unnecessary article of furniture should be cleared out of the room, and nothing must be left in it which afterwards cannot be submitted to thorough fumigation or destruction. In treating infectious diseases in the patient's borne, it is a good plan to place a large vessel filled with water and Condy's Fluid (about i in 5o) outside the door of the sick-room. Into this vessel all articles leaving the room may be dipped. In the case of scarlatina and smallpox, a sheet moistened occasionally in a solution of Carbolic Acid (r in 8o) or Chlorinated Lime (1 in 2oo) may be suspended outside the door, in order to more effectually cut off the room from the other parts of the house; the same plan should be carried out in measles when other children are residing in the household. Urine and farces should be passed into vessels containing a small quantity of some disin fecting or deodorising substance. Terebene, Eucalyptus, Carbolic Acid, or other volatile antiseptic may be diffused through the atmosphere occasionally by a spray apparatus.
The treatment must be entirely symptomatic; no known drug exercises any specific action over the causal morbific agent.
The following old-fashioned mixture can do no harm, and often affords some relief by encouraging the action of the skin; it may be administered till the decline of the eruption in doses of a teaspoonful every 2 or 3 hours to a child 2 to 5 years old.