Friday, October 21, 2016

Measles

In the Medical Lexicon of 1865 Measles is described as:
MEASLES, ( [G.] Mase, 'a spot,' masern, 'spotted.') Rubeola. Also, a diseased condition of pork — measly pork — which bus been ascribed to the presence of cysticcrcus collulossc; and may be owing to trichina); see Trichiniasis.

In the The family medical guide: ©1871 a description of the disease and treatment is:
MEASLES.
This is an infectious fever, affecting the skin and also the mucous membrane, especially that of the eyes, nostrils, throat, and air-tubes.

This disease is met with chiefly in youth, but it may occur in advanced age. It is one of those diseases to which, as a rule, we are subject once only during life; but to this, exceptions occur occasionally, and we meet with patients having measles who are reported to have suffered from it before. But as the first attack had not been seen by me in any of the cases I allude to, and as they were said to be very mild, without cough, or weakness of the eyes, it seemed possible that the special fever was also absent; and that the former disease had been more allied to rose-rash than measles.

The fever does not set in immediately after the person is exposed to contagion. The poison generally remains latent in the system from ten to fifteen days, which period is called the term of " incubation."

The first symptoms of the effects of the poison acting on the blood are a feeling of lassitude, sensation of chilliness, loss of appetite, and a rigor or shivering fit, followed by a hoarse cough, discharge from the nostrils, and weak eyes.
Most patients complain also of pain of back or head, and some of both, while the skin is hot and dry, and the pulse full and quick.

Next we notice an eruption or rash upon the forehead and face, but so little distinctive, that but for the weakness of the eyes, and tendency to cough, we could not yet recognize the disease to be measles. The eruption, however, soon extends to the chest and extremities; the small, dry vesicles coalesce; the face becomes swollen; and the peculiar purple colour of the skin declares the nature of the disease.

In some cases the eruption appears only partially, and the inexperienced fancy, therefore, that the disease is mild ; but the reverse is the fact, for either a slight eruption or the sudden disappearance of the eruption is always the harbinger of evil.
Treatment.—In this and every other fever, the patient, from the first symptoms, should be confined to bed. The horizontal position does much to quiet the action of the heart, and equalize the circulation of the blood, while complete exemption from muscular exertion places the constitution in a favourable position to contend with the disease.
A uniform temperature, suited to the nature of the case, can only be ensured in bed; and, in measles especially, to avoid chilling draughts is necessary.

On account of the weakness of the eyes, the room should be kept darkened by a green shade to the windows ; and, owing to the irritability of the air-tubes, currents of cold air must be guarded against; because weakness of eyes, hoarseness, or loss of voice, remaining after convalescence, is almost certain to be permanent for life.
The quantity of bed-covering should be regulated by the feelings of the patients ; just enough to keep them comfortably warm; while the feet should be carefully attended to, and a footpan of hot water applied, if it be necessary, or bags of heated salt.

To drink freely of toast-, barley-, or rice-water, or rennet whey, or apple-tea, made by pouring hot water on raw apples, sliced, is sufficient nourishment for the first two or three days, till the cough and fever abate ; ten grains of nitre, and three grains of the carbonate of ammonia, being given in such drink, alternately, every four hours.
The popular idea is that persons when sick require to eat to be able to bear the disease, but this impression is very erroneous ; for while fever is in the system, the power of digesting food is held in abeyance, and, consequently, solid food taken into the stomach must aggravate the disease, and increase the weakness of the sufferer. It is only by fluids such as can be absorbed without being digested, that patients can be nourished during the continuance of fever.

When fever abates, the tongue cleans, and appetite begins to return, farinaceous food, as ground rice, arrowroot, sago, or maizena, boiled in water, and eaten with a little milk, is proper food; but tea, coffee, and all alcoholic stimulants are injurious.
At the commencement of fever, it is always salutary to unload the biliary ducts, liver, and bowels. Calomel was formerly the medicine for this purpose, but podophylline does the same service, and is a safer remedy. Half a grain of the latter, with ten grains of Epsom salts, in syrup or pills, taken every night, for two nights in succession, is sufficient; the bowels being afterwards regulated by two grains of aloes and ten of Epsom salts, given as often as required. But as the fever subsides, diarrhoea generally sets in, and renders aperients unnecessary.

In mild cases, with proper care, the nitre and carbonate of ammonia, in which I place great confidence, are all the medicine that is required, except for the bowels. For children, the acetate of ammonia does equally well, and it is more palatable. It is made by dropping the carbonate of ammonia into a two-ounce bottle of table vinegar, until effervescence ceases, when the bottle should be corked for use, and a teaspoonful should be given in place of the carbonate to a child of twelve years, and half that quantity to one of six years.

But if the cough be troublesome, six grains of Dover's powder should be given in a little syrup, at night, to a male adult, five grains to a female, and less in proportion to age ; one grain being sufficient for a child of two years. And if pain of chest be present, a mustard plaster should be applied, kept on till the skin is red, and repeated evening and morning till pain is relieved.

After fevers causing an eruption on the surface, the cuticle or scarf skin exfoliates, and the true skin, in which so many nervous fibrils terminate, is denuded of its wonted covering. Getting out of bed too soon, or any chill, is therefore calculated, owing to sympathy with the skin, to increase the irritability of the air-tubes, and cause determination also to the lungs, which may destroy life.

A week after the eruption disappears is soon enough for the patient to get up ; and during that week the diet should be altered to a lightly-boiled egg, with a cup of tea and dry toast for breakfast; chicken broth, beef or mutton tea, with stale bread, for dinner ; and ground rice or maizena, boiled in water, and eaten with milk, in the evening.
When the patient gets out of bed, solid animal food can be returned to, taking care that it be light and easily digested at first, and only in moderate quantity ; and half a grain of quinine should now be taken after breakfast and dinner, unless it causes headache, and if so, a wineglassful of infusion of chiretta or quassia should be substituted for it.
To prepare the patient for exposure to the open air, a tepid shower bath should be taken every morning, and cooled down gradually to a cold bath.

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