the other "little fevers,"
the first thing to mark off measles is usually that the itching and
running at the nose and eyes become more prominent, the child begins to
turn its face away from the light because it makes its eyes smart, and
complains not so much of soreness as of a peppery, burning, itching
sensation in its nose and throat. The tongue is coated, the stomach
mildly upset; the little patient is more uncomfortable and fretful than
seriously ill. This condition drags on, without apparently getting
anywhere, for from two to four days, during which time it is often very
difficult even for the most experienced physician to say positively what
the sufferer has. But about the fourth day a rash begins to appear,
typically first upon the cheeks or forehead in the shape of little
widely separated dull-red blotches. These grow larger and deeper in
color, rising in the middle and spreading at their edges, so that
shortly the whole skin becomes puffed and swollen and of a mottled,
pinkish-purple color. If the child's lower lip be pulled down, little
red spots will be seen scattered over the lining membrane of the mouth,
showing that the eruption is not confined to the skin. Indeed, these
Koplik's spots (as they are called, after their discoverer) in the mouth
will often appear a day or more before the eruption upon the skin and
give the first clew to the nature of the disease. These are significant,
because they probably illustrate the process of eruption, or, at least,
irritation, which is taking place, not merely upon the skin, but also
upon the mucous membranes of the eyes, nose, and throat, the windpipe
and the bronchial tubes, and which is the cause of the burning, running,
and, later, occasional serious inflammatory symptoms in all these
regions.

When you look at the hot, angry-looking, swollen skin of the little
victim of measles, the weeping eyes and running nose, and remember that
this same sort of process is either going on or is likely to occur all
over his entire lining, so to speak, from lungs to bowels, you can
easily grasp how important it is to keep him absolutely at rest and
protected from every possible risk in the way of chill, over-exertion,
or injudicious feeding, until the whole process has completely subsided
and been forgotten. Neglect of these precautions is the reason why so
many cases of measles, on the least and most trifling exposure and
overstrain during the two or three weeks following the