Rubella.

Synonyms.—Rotheln; Rubella Notha; Epidemic Roseola; German Measles; French Measles; Hybrid Measles; Bastard Measles.

Definition.—An acute contagious disease, characterized by an eruption of a papular form, resembling in some respects both measles and scarlet fever, and in others, possessing characteristics not present in either. A mild fever, accompanied by enlargement of the lymphatics, especially the cervical, submaxillary, auricular, and suboccipital.

Etiology.—It is propagated by a contagion, though the exact nature of the poison is not known. It is specific in character, and one attack generally insures exemption from another, though it does not afford immunity from either measles or scarlet fever. It generally occurs as an epidemic, and affects children rather than adults, though age is no barrier to the disease. The contagion is spread in the clothing by fomites, exhalations from the skin, and also probably by the other excretions.

Symptoms.—This is one of the mildest of the eruptive diseases, if we except varicella. The stage of incubation is from ten days to two weeks.

The stage of invasion varies; in some the appearance of the eruption is the first evidence of the disease, though usually there is some chilliness, headache, pain in head, back, and limbs, coryza, slight sore throat, and tenderness and swelling of the superficial lymphatics of the neck.

The fever is mild, the temperature rising to about 100°, though in rare cases it may reach 103°. The eruption usually appears within twenty-four hours after the invasion, upon the face and neck, gradually extending over the whole body, and this may be the first evidence of the disease. The eruption consists of a number of small, round, or oval papules, pinkish in color, and may be discrete or confluent. It lasts from two to five days, when it is followed by a slight desquamation, and sometimes by a brownish staining of the skin, which disappears after a few days.

During this period there will be, in many cases, an inflamed condition of the throat, and the tonsils become swollen and painful. The inflammation is superficial, and not attended by sloughing. Sometimes a bronchial cough attends this stage. Though there is glandular enlargement, there is never suppuration. The disease passes through its various stages to a favorable close without serious complications or sequelae.

Diagnosis.—The diagnosis is made from measles by its less severe onset, the absence of catarrhal symptoms, the more pinkish or rose color of the eruption, and early enlargement of the cervical lymphatics; from scarlet fever, by the slight fever, the absence of the strawberry tongue, no vomiting, and the more pronounced erythema of the latter.

The Prognosis is favorable.

Treatment.—This is very simple; aconite and phytolacca being almost a specific, the one correcting the fever, the other influencing the lymphatic system. Where there is nervous irritation, or where there is a burning sensation attending the eruption, rhus tox. may be substituted for the phytolacca, or, what is still better, used in alternation with it. The patient may be sponged with warm water, and when there is much pruritis, use the bacon rind as a means of inunction. The patient should also be anointed while desquamation takes place.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.