Delirium in the early stage is due to the intensity of the fever, and yields to antipyretic treatment; at a later stage it may indicate meningeal trouble, and should be treated by closely clipping the hair and applying the ice-cap.
Convulsions at a later stage, like delirium, generally indicate the onset of some serious complication, such as pneumonia or meningitis, which is to be met by the administration of such remedies as are indicated in these affections.
The onset of any serious symptom, if accompanied by the sudden fading or recession of the rash, may be met by a brief immersion of the child's body in a hot bath containing mustard, but if this treatment is adopted cold should be applied to the head during the bathing.
Pneumonia is a most serious complication, usually taking on the type of capillary bronchitis or broncho-pneumonia; it often runs a slow course, and must be met by poultices and stimulating expectorants, as Ammonia, &c., described in the article on p. 108. Strychnine for symptoms of heart failure may be indicated, along with small doses of Alcohol, and Oxygen inhalations should be resorted to if cyanosis supervene. As the pneumonia of measles, like that of influenza, is infectious, a child suffering from this complication should not be treated in the same room with other measles patients.
Troubles in the middle or internal car, ophthalmia, adcnitis and other complications are to he met by the remedies mentioned under the names of these affections, and since the microbes which cause many of the complications of measles are always to be found in the mouth, Dawson Williams points out the necessity of disinfecting mouth-washes and sprays. These latter arc of great value in preventing otitis, and they may be supplemented by careful syringing or washing out of the naso-pharynx, immediately after which gentle Politzerisation may be occasionally carried out.
Alcoholic stimulants are seldom necessary in ordinary uncomplicated cases, but where serious complications as those just mentioned are present they must be judiciously administered. Wine whey is the best form for the administration of alcohol, and it is usually readily taken by children. A wineglassful of Sherry added to a pint of boiling milk causes curdling, and the curd should he strained out or permitted to settle down.
In the presence of whooping-cough as a complication of measles stimu lation is usually necessary. Any suspicion of a diphtheritic membrane on the throat should be immediately met by serum-therapy.
The exhaustion and serious drain made upon the system by a severe attack of measles often lead to a fatal issue, notwithstanding the popular notion that the disease is generally a trivial ailment; hence, after the decline of the eruption, every care must be taken to keep up the general strength by large quantities of easily digested and easily assimilated food.
The after-treatment is sometimes of much greater importance than the management of the case prior to the decline of the fever. Tonics may be needed to improve the appetite, and Iron to combat the which often results. These objects may be accomplished at the same time by giving a mixture containing Quinine, with small closes of the Tincture of Iron. Cod-Liver Oil is very valuable at a later stage.
As branny desquamation sets in the skin may be anointed, after a warm bath and drying, by Olive Oil containing 5 per cent. Eucalyptus Oil; this relieves all itching and tends to diminish the spread of the disease to others.
The patient may generally be permitted to leave his bed, in the absence of complications, though still to remain in his room, after the lapse of a week. It is difficult to keep those who have just passed through a mild attack of measles from exposing themselves to the variations of tempera ture outdoors. The children of the poorer class run about in the open air often before the eruption has entirely faded, and the result is that numbers of them perish from secondary bronchial or pneumonic troubles. The dangers of exposure should be insisted upon to parents, and the body should be well enveloped in flannels, even in the summer-time. In winter, a child should not he permitted to take open-air exercise for at least a month after the seizure. Drives should not he permitted till the patient has been allowed to move about.
To al] who have had much experience in the extern department of a children's hospital, it is evident how numerous are the cases of phthisis and severe visceral and hone affections. whose origin can he trared to the shattered state of health following measles. which depresses the natural resistance to the omnipresent tubercle bacillus, and permits of its unop posed progress. These grave sequelT are certainly more common after measles than after the other members of the exanthemata. and this con sideration points to the real necessity for prolonged careful feeding by highly nourishing food and by milk, sterilised or Pasteurised, together with every form of improved hygiene possible.