The eruptive fevers are all divided into three stages, namely: a stage
of invasion or development; a second stage when the eruption appears,
and while it lasts; and a third stage, that of _desquamation_, when the
eruption begins to fade or exfoliate in branny scales.
(_j_) Measles is generally a mild and not serious disease, and only
attacks the individual but once in a lifetime; only through gross
carelessness the disease becomes complicated, and then it may become a
very dangerous affection. It begins with all the symptoms of a common
cold. There is frequent sneezing, and an acrid muco-serous discharge
from the nostrils. The eyes are irritable, reddened and watery, and
there is more or less intolerance of light. The voice becomes hoarse
and there is always a bronchitis present which is characterized by
a dry, harsh cough. The patient is generally feverish, alternating
with chilly sensations or shivering; the appetite is poor or absent
and in some cases there is nausea and vomiting. The children feel
drowsy; they complain of pain in the head and limbs and want to lounge
around. The bowels may be constipated, but diarrhœa supervenes in
a certain proportion of cases. In nervous children convulsions may
occur; bleeding from the nose and false croup are not infrequently met
with in the development of this disease. The duration of the first
stage varies greatly in different individuals, and comprises a period
extending from one to seven days. The eruption begins generally on the
temples and forehead, whence it extends over the head and neck, thence
down the back and over the entire body, occupying in its development
from thirty-six to forty-eight hours. The eruption bears a resemblance
to flea bites at first; it appears as minute red specks which gradually
enlarge and become slightly elevated and arrange themselves in circular
clusters. The portions of the skin that are free from the eruption
retain their white appearance; the face is more or less swollen and the
eyelids puffed. In some patients there is considerable annoyance from
itching in the skin. The cough and bronchitis continue to be prominent
symptoms, and the expectoration, consisting of yellowish sputa becomes
abundant. In some children the fever runs very high in this stage and
they become delirious and restless, but this is only temporary, for it
generally diminishes with the eruption on the third or fourth day.
When the eruption begins to fade the third stage of the affection is
inaugurated, and when there exist no complications, the patient may now
be considered on the way to recovery which takes from four to eight
days longer.