HISTORY 135F

Infectious and Epidemic Disease in History

Department of History
University of California, Irvine
 Instructor:    Dr. Barbara J. Becker

Week 6.  Contagion? On the Measles from Chapter XIV, Processus integri (1692) by Thomas Sydenham (1624-1689)

The measles generally attack children.  On the first day they have chills and shivers, and are hot and cold in turns.  On the second they have the fever in full -- disquietude, thirst, want of appetite, a white (but not a dry) tongue, slight cough, heaviness of the head and eyes, and somnolence.  The nose and eyes run continually; and this is the surest sign of measles.  To this may be added sneezing, a swelling of the eyelids a little before the eruption, vomiting and diarrhea with green stools.  These appear more especially during teething time. The symptoms increase till the fourth day.  Then -- or sometimes on the fifth -- there appear on the face and forehead small red spots, very like the bites of fleas.  These increase in number, and cluster together, so as to mark the face with large red blotches.  They are formed by small papulae [pimples], so slightly elevated above the skin, that their prominence can hardly be detected by the eye, but can just be felt by passing the fingers lightly along the skin. 2. The spots take hold of the face first; from which they spread to the chest and belly, and afterwards to the legs and ankles.  On these parts may be seen broad, red maculae [discolored spots], on, but above, the level of the skin. In measles the eruption does not so thoroughly allay the other symptoms as in small-pox.  There is, however, no vomiting after its appearance; nevertheless there is slight cough instead, which, with the fever and the difficulty of breathing, increases.  There is also a running from the eyes, somnolence, and want of appetite. On the sixth day, or thereabouts, the forehead and face begin to grow rough, as the pustules die off, and as the skin breaks.  Over the rest of the body the blotches are both very broad and very red.  About the eighth day they disappear from the face, and scarcely show on the rest of the body.  On the ninth, there are none anywhere.  On the face, however, and on the extremities -- sometimes over the trunk -- they peel off in thin, mealy squamulae [scales]; at which time the fever, the difficulty of breathing, and the cough are aggravated.  In adults and patients who have been under a hot regimen, they grow livid, and afterwards black.

	[apothecary's symbol from the Latin word recipere, meaning "to take"]
	Pectoral decoction, 1-1/2 pints; Syrup of violets, Syrup of maidenhair, 1-1/2 ounces. Mix, and make into an apozem.  Of this take three or four ounces three or four times a day.
	Oil of sweet almonds, 2 ounces; Syrup of violets, Syrup of maidenhair, 1 ounce; Finest white sugar, sufficient quantity Mix, and make into a linctus; to be taken often, especially when the cough is troublesome.
	Black-cherry water, 2 ounces; Syrup of poppies, 1 ounce. Mix, and make into a draught; to be taken every night, from the first onset of the disease, until the patient recovers:  the dose being increased or diminished according to his age.

3. The patient must keep his bed for two days after the first eruption. 4. If, after the departure of the measles, fever, difficulty of breathing, and other symptoms like those of peripneumony supervene, blood is to be taken from the arm freely, once, twice or thrice, as the case may require, with due intervals between.  The pectoral decoction and the linctus must also be continued; or, instead of the latter, the oil of sweet almonds alone.  About the twelfth day from the invasion the patient may be moderately purged. 5. The diarrhea which follows measles is cured by bleeding.