The only remaining affection of the proper exanthe matous kind is the Measles, a disease which is charac terized by a fever of the inflammatory type, together with all the symptoms of a violent catarrh, and parti cularly by a copious discharge of watery humour from the eyes and nose. About the fourth day an eruption of small red points makes its appearance all over the surface of the body, which, after continuing three or four days, disappears without proceeding to suppura tion, and is succeeded by the desquamation of the cuti cle, in the form of small hranny scales ; the fever and catarrhal affection disappear about the same period. A very remarkable circumstance in the history of medi cine is, that Scarlatina and Rubeola were not properly distinguished from each other until about the com mencement of the last century, a circumstance which has led some writers to suppose that Scarlatina is en tirely a disease of modern times, and that it did not exist until just previous to that period, in which it was first noticed as a distinct affection from Rubcola ; but, upon the whole, ne do not see sufficient evidence for this opinion. The diagnosis between the two complaints, in mild casts, is perhaps not always very easy, nor is it very important ; but whenever they arc either of them severe, no difficulty occurs in the discrimination, and it then becomes a very important practical point, as they are of an opposite tendency, and require very different modes of treatment.
The measles, in every part of their course, exhibit an inflammatory aspect, and indicate the antiphlogistic regimen. Unless the constitution be predisposed to pulmonary affections, the disease be unusually severe, occur in very early infancy, or under some peculiarly disadvantageous circumstances, Rubeola is not a very dangerous complaint, but it is one in which it is neces sary to act, in the earlier stages, with promptness and vigour, as, if this opportunity be suffered to pass by, our remedies will be far less efficacious, or perhaps altoge ther inapplicable. The degree to which we are to carry the antiphlogistic system must be determined by the circumstances of the individual case, by the character of the prevailing epidemic, the season of the year, and other collateral circumstances. Bleeding, either gene ral or local, will be often necessary ; purgatives are always proper, and we are carefully to maintain a regu lated temperature, avoiding the extremes of heat, but shunning the direct application of cold. Any circum stance which may cause the sudden disappearance of the eruption is always to be guarded against, as indi cating a dangerous state of inaction in the sanguiferous system ; and, should it occur, it must be removed by the means that were pointed out with respect to Small pox. The cough is sometimes so troublesome a symp tom as to require particular attention ; but, for the most part, whatever relieves the febrile state will relieve the affections of the chest. Attempts have been made to produce the disease by inoculation, but it does not ap pear that any great benefit is obtained, or that the dis ease, when communicated in this way, is mitigated in the same manner as it is in Small-pox.
There arc two other diseases, that are usually placed by s)stematic writers among the exanthemata, although it would appev-*without any sufficient claim to this situation, Urticaria or Nettle-rash, and Pemphigus. 'ley both consist of peculiar eruptions, the former, as its name indicates, very much resembling the sting of a nettle, the latter consisting of large irregular vesi cles. A degree of fever attends them, but it is uncer tain what relation the topical bears to the general affection; and as they arc diseases not very well cha racterized, and often so slight as not to become subjects of medical treatment, we have not much accurate infor mation respecting them. Urticaria is generally con ceived to depend upon a peculiar state of the stomach and bowels; and Pemphigus appears to be symptoma tic of, or consequent to, a general morbid condition of the system. Their treatment chiefly consists in remov ing any obvious sources of irritation, and in restoring the healthy state of the digestive organs.
We have placed Erysipelas as an appendage to the genus Exanthema, because, although wanting some of its characteristic circumstances, it seems to be more allied to it than to any other class of diseases. It con sists of a fever, which is succeeded, at a certain period, by a cutaneous affection ; the fever is of the inflamma tory type, is attended with a degree of drowsiness, or even sometimes with coma and delirium; the head and face arc hot and swelled, and a considerable part of the surface is attacked with an inflammation, which fre quently produces large vesications that become filled with a serous fluid; it usually appears on the face or on the extremities. This disease differs materially from the other Exanthemata, in occurring more than once to the same individual ; indeed, when a person has been affected by it, he is ever afterwards peculiarly liable to its attacks. Its exciting cause is obscure; it attaches itself to particular constitutions, which, however, it is not easy to characterize, and seems to have some con nexion with peculiar states of the atmosphere, as it is epidemic in certain situations, as in hospitals, or other places where numbers of sick are crowded together, and especially patients suffering from wounds or surgi cal operations. It is doubtful whether it be ever pro perly contagious ; but, upon the whole, the evidence ap pears to be in favour of its not being so. It has been thought that, when the disease prevails epidemically, as in hospitals, its symptoms differ from those of the cases that occur sporadically, and that in the former instances it assumes altogether a different type, possessing more of the malignant or typhous character ; we are inclined, however, to doubt this conclusion, and are more dispos ed to attribute it to the greater violence of the com plaint under these circumstances, in consequence of which its primary symptoms arc more highly inflamma tory, and are therefore succeeded by a state of greater exhaustion.