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Poisoning Matches

measles, children, eruption, time, usually, days and infection

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MATCHES, POISONING BY.—Sec PuosmoRus-PotsomxG.

MEASLES.—An acute, eruptive, infectious disease, the cause of which is as yet unknown. It is very contagious, and during an epidemic of measles a child previously unaffected rarely escapes. One attack of measles usually renders the individual immune to the disease, and for this reason adults are seldom affected, since they have generally had measles as children. In large institutions (insane asylums, gaols, etc.) adults may, however, frequently contract the disease. The average time elapsing between the infection with the virus of measles and the appearance of the eruption upon the skin is fourteen days. Prior to this, there appear so-called " forerunners " (prodromi), such as cough, running from the nose and eves, and high fever of short duration. After these prodromi have been present for three days the eruption appears, usually with a marked rise in temperature (see Fig. 274). This eruption, which begins in the face, usually spreads over the entire body within twenty-four hours. It consists of light or dark red spots, slightly raised above the skin, and varying in size from that of a pin-head to that of a pea. They occur either as isolated spots, or they may merge into large patches, covering extensive areas of skin. The catarrhal pre monitory symptoms (particularly the cough) are usually aggravated upon the appearance of the eruption. Three or four days after its onset the eruption begins to fade, those spots which appeared first being also the first to vanish. At the same time the fever begins to abate ; the running of the nose and eves becomes less troublesome ; the cough loosens ; and the skin peels off in bran-like scales. If nothing disturbs the course of the affection, the children should remain in bed from six to ten days. They should not leave the room for another eight days, and under no circumstances before the scaling-off process has terminated. The time is best determined by the physician, who will take into consideration the season, the condition of the weather, and the general state of the child's strength.

The course of the affection is not always as favourable as described ill the foregoing. Various diseases (such as pneumonia, exhausting diarrhoea,

croup, inflammation of the middle ear, etc.) may supervene, which will delay recovery, or perhaps cause death. Inflammation of the middle ear may begin very inconspicuously. When a child who has recovered from measles complains of pain in the ear, or when one who cannot speak frequently takes hold of the ear, the physician's attention should at once be called to this symptom. In rare cases the virus of measles may be so powerful that the affected person dies within a short time, Tuberculosis often develops in connection with measles ; or, if it has been present prior to the attack, its progress is considerably furthered.

Owing to the great susceptibility of children to the poison of measles, many parents do not pay much attention to the prevention of the disease ; in fact, they even purposely expose the healthy children to the infection, in order that all the children may pass through the affection at the same time. This method is very dangerous, and even criminal. If the malady unex pectedly runs a severe course and terminates fatally, ur if a child suffers lasting impairment of health, parents should reproach themselves most severely. Children under five years of age (especially those who suffer from rickets, scrofula, tuberculosis, or chronic bronchitis) should always be carefully protected against infection ; older, healthy children only when the epidemic is a malignant one. Effective prevention, however, is possible only by removing the children to a locality free from measles immediately upon the appearance of an epidemic. If nothing be done until the infection has actually entered the house, it is usually too late, as measles is probably infectious before the appearance of an eruption. The possibility of infection ceases when the eruption fades. Measles can be transmitted neither by healthy persons nor by household utensils. In children who have not had measles, every attack of cold in the head, accompanied with cough and with running from the eyes, should be regarded with suspicion, and proper precautions taken.

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