eglectful and
complications occur, and these frequently prove fatal. One attack
renders the patient immune. It is very highly contagious and spreads
with great rapidity among those who have never had it. It is not
possible to carry the disease any great distance by a third person or by
means of living objects. It does not, however, cling to clothing or
other objects as long as scarlet fever. Its period of incubation is from
eleven to fourteen days.

Symptoms.--The symptoms develop gradually. A severe cold in the head
is the first and most characteristic symptom of the disease. There is a
discharge from the nose, swollen and watery eyes, sneezing and a hoarse,
harsh cough. The patient may complain of the throat being painful and
examination will reveal a general congestion of the parts. There are
also headache, lassitude, pains in the back, and there may be vomiting
and diarrhea. Children in the early stages of measles are tired and
sleepy.

Koplik's Spots.--Three or four days, in rare cases somewhat longer,
before the appearance of the rash there appears on the mucous membrane
of the cheeks small, bluish white, or yellowish white points, the size
of a small pin head. These points are surrounded with reddened areas
which give the appearance of a general rash with fine white points upon
it. These points resemble milk particles. They adhere firmly to the
mucous membrane and when an effort is made to remove them it is found
that the underlying surface is ulcerated and excoriated.

The Koplik spots are not of much value to the mother other than that
they may be relied upon to indicate the coming disease with which they
child is affected. Physicians look for them as an aid in diagnosis
before the rash would of itself indicate the disease.

The rash appears on the third, fourth, or fifth day of the disease. From
the day of the infection to the outbreak of the rash about thirteen days
intervene. It is seen first at the roots of the hair on the forehead,
behind the ears or on the neck. It may be seen first on the cheeks. The
beginning rash appears as small, dark red, dull spots. At first there
are only a few, but they soon become more numerous, they join together,
and soon the surface looks inflamed as if entirely covered with the
rash. The rash covers the entire body, including the soles and palms. In
twenty-four hours it is at its height on the face. It spreads downward
like a wave, first the face, then the neck and chest,