When an epidemic of measles is prevailing, great care should be taken to prevent exposure to the disease. This cannot always be done, as the popular dread of the disease is not sufficiently great to induce the entire isolation of persons who are suffering with it. Various experiments have been made which seem to indicate that a degree of protection may be afforded by inoculation with the virus of the disease, as was practiced as a means of protection from smallpox before the discovery of vaccination. Inoculation has never been extensively practiced, however, and is of doubtful propriety.

In mild cases, very little treatment is required except such as is necessary to make the patient comfortable. Good nursing is much more important than medical treatment. If the eruption is slow in making its appearance, or is repelled after having once appeared, the patient should be given a warm blanket pack. The cold pack is most commonly used in Germany, but we have obtained equally good effects from the warm pack, and it is much more comfortable for the patient.

When the fever rises high, it should be subdued by tepid sponging, cool compresses to the abdomen, renewed as frequently as they become warm, and the cold enema. Cold packs and affusions, although in no degree dangerous, and highly recommended by many eminent physicians, are rarely required. Thomas, the eminent author of the article on measles in Ziemssen's Encyclopedia, says in reference to the treat ment of this disease, "At present, cool baths, packings, and extensive cold compresses are the usual means employed. The advantages of a judiciously administered cold-water treatment in measles are, that it usually affords to the patient more speedily and safely than any other anti-febrile method, a certain sense of comfort; that it is not apt to weaken or otherwise act unfavorably; and that it shortens convalescence by permitting the patient to expose himself to the fresh air sooner than under any other treatment."' Care should be employed in sponging the skin not to aggravate the irritation by rubbing. In drying the patient, the skin should be patted with a soft towel instead of being rubbed.

The old-fashioned plan of keeping the patient smothered beneath heavy blankets, and constantly in a state of perspiration, is wholly unnecessary, besides rendering the patient very uncomfortable. The irritation of the skin, as well as the sensitiveness to cold, may be much relieved by inunction of the skin two or three times a day with vaseline, sweet oil, fresh butter, or any other good unguent. No fears whatever need be entertained that the eruption will be driven in by cold applications, as there is no danger whatever from the application of cold water to the surface, except in the last stages of the disease, after the eruption has disappeared. No hesitation need be felt in applying compresses and sponging to reduce the fever on account of the cough, as this will generally be found to be the best means for relief. Convulsions require warm baths. Delirium and great restlessness indicate congestion of the brain. A slight diarrhea need give no occasion for alarm. If this symptom becomes very troublesome, a cool enema should be employed two or three times a day. The occurrence of pneumonia indicates the necessity for the employment of such measures as are elsewhere recommended for that disease. If croupy symptoms appear, ice compresses should be applied to the throat. If this does not secure relief, the throat and chest should be lightly sponged with water as hot as can be borne, care being taken not to bum the skin. Hot fomentations are also useful. If severe capillary bronchitis occurs, causing greatly diminished respiration, accompanied by high fever, Ziemssen recommends the use of the cold pack, which he thus describes: "Several thicknesses of cloth wrung out of cold water are laid upon a piece of flannel of sufficient width to protect the bedclothes from becoming wet The naked patient is then placed upon the sheets and enveloped in them. Lively kicking and scream ing ensue, giving depth and force to the previously superficial inspiration. By degrees the child becomes more quiet, and soon falls asleep. The cold wrappings are to be renewed every half-hour or so, until the temperature, pulse, and frequency of respiration are remarkably diminished. This is usually the case in a couple of hours."

This treatment may seem quite heroic, but it is recommended by the highest medical authority in the world. With reference to the old sweating method of treatment, Prof. Thomas, previously quoted, remarks that "although it has been given up by thousands in the treatment of measles, notwithstanding, prejudices are still entertained by many against the use of baths, even warm, on account of the supposed possibility of their exerting an unfavorable influence upon the cough and catarrh of the air-passages in general. It is to be hoped that the favorable results of hydrotherapeutics may overcome this prejudice, and that ventilation and cleanliness may in future epidemics gradually cause pneumonia and the other dangerous complications of measles, and, we think, their mortality, to sink to an unavoidable minimum."

The patient should be allowed cooling drinks, as much as desired. During the disease, a simple, but nutritious diet should be allowed, but stimulants of all kinds should be prohibited. Milk, fruits, and grains may be taken in sufficient quantity to satisfy the patient's appetite, but meat should be prohibited. Good ventilation of the sickroom should be maintained throughout the disease, and care should be taken to prevent, so far as possible, the contraction of the disease by those who have never had it.

After recovery, all the clothing employed about the patient, including bedding, should be thoroughly disinfected. The sick-room should first be disinfected by burning sulphur. It should afterward be thoroughly scrubbed and aired. This is not so important as in some other infectious diseases, but will do no harm, and may be the means of preventing severe illness and death.

German Measles or Rubeola

This disease so closely resembles the preceding that its independent existence is not fully recognized by physicians. Persons not skilled in diagnosis would certainly be unable to distinguish it from measles. It is claimed, however, that an attack of rubeola affords no protection from measles, and vice versa. The treatment and general management of the disease is precisely the same as that of measles, however, and hence we need not give it further attention here.