minary period, when the patient seems to be suffering with a
bad cold, lasts for four days usually, and on the evening of the
fourth day the rash breaks out. It first appears on the face and then
spreads to the chest, trunk, and limbs. Two days are generally
required for the complete development of the rash; it remains thus in
full bloom for about two days more, then begins to subside, fading
completely in another two days--six days in all.

The rash appears as bright-red, slightly raised blotches on the face,
which is generally somewhat swollen. The same rash extends to the
abdomen, back, and limbs. Between the mottled, red rash may be seen
the natural color of the skin. At this time the cough may be hoarse
and incessant, and the eyes extremely sensitive to light. The fever
and other symptoms abate when the rash subsides, and well-marked
scaling of the skin occurs.

=Complications and Sequels.=--Severe bronchitis, pneumonia, croup,
laryngitis, sore eyes, ear abscess and deafness, violent diarrhea,
convulsions, and, as a late result, consumption sometimes accompany or
follow measles. For the consideration of these disorders, see special
articles in other parts of this work.

=Outlook.=--The vast majority of healthy patients over two years old
recover from measles completely. Younger children, or those suffering
from other diseases, may die through some of the complications
affecting the lungs. The disease is peculiarly fatal in some epidemics
occurring among those living in unhygienic surroundings, and in
communities unaccustomed to the ravages of measles. Thus, in an
epidemic attacking the Fiji Islanders, over one-quarter of the whole
population (150,000) died of measles in 1875. Measles is more severe
in adults than in children.

=Diagnosis.=--For one not familiar with the characteristic rash a
written description of it will not suffice for the certain recognition
of the disease, but if the long preliminary period of catarrh and
fever, and the appearance of the eruption on the fourth day, be taken
into account--together with the existence of sore eyes and hoarse,
hard cough--the determination of the presence of measles will not be
difficult in most cases.

=Treatment.=--The patient should be put to bed in a darkened,
well-ventilated room at a temperature of 68 deg. to 70 deg. F. While by
isolation of the patient we may often fail to prevent the occurrence
of measles in other susceptible persons in the same house