s do not, as in small-pox, become less severe immediately on the
appearance of the eruption, but continue just as troublesome as before
for twenty-four hours or more, the voice being hoarse, the cough even
more incessant, and the throat often slightly sore and red. Soon,
however, improvement becomes apparent, the fever lessens, the cough
grows looser; and in less than a fortnight the patient is usually
convalescent.

The above is pretty nearly the ordinary course of measles, for we do not
meet with that extreme variation in its severity which is observed in
scarlatina, where one child will seem scarcely to ail at all, while its
brother or sister may be in a state of extreme peril. It is not wise,
however, to trust a case even of apparently mild measles to domestic
management, for while the cough is troublesome in almost every case, the
ear of the experienced doctor is needed to ascertain whether it is
merely the cough of irritation which attends the measles, or the graver
cough due to bronchitis.

One other caution will not be out of place. The danger of exposure to
cold is very real, but that does not necessitate the loading the child
with excessive covering, or the abstaining from washing its hands and
face. The child should be kept moderately cool; and sponging its hands
and face frequently with tepid water soothes it and relieves the painful
irritation and itching.

=German Measles.=--There is a disorder which seems to hold a middle
place between measles and scarlatina, akin to both, identical with
neither, and furnishing no sort of protection from their occurrence.

It is known in this country by the name of _German measles_, or
sometimes by its German name of _Roetheln_; the first clear description
of its character having been given by German writers.

It is unfortunate that a very slight resemblance of some of its symptoms
to those of scarlet fever has led to its being sometimes mistaken for
it, and as the ailment is almost always very trivial, doctors anxious to
avoid alarming their patients' friends, too often allow the error to go
unrectified, and the disease to pass as one of mild scarlet fever.

The resemblance of German measles to scarlet fever is, however,
extremely slight, and is almost entirely limited to the existence of a
slight sore-throat, unaccompanied with glandular swelling. The rash in
no respect resembles the uniform redness of the scarlatinal eruption,
and there is no peeling of the skin,