Identifier: medicaldiagnosi00gree (find matches)
Title: Medical diagnosis for the student and practitioner
Year: 1922 (1920s)
Authors: Greene, Charles Lyman, 1862-
Subjects: Diagnosis
Publisher: Philadelphia, Blakiston
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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following the entrance intothe camps of the first draft during the fall of 1917. In this earlier epidemicpulmonary complications were astonishingly frequent and this was especiallytrue of empyema. Morbid Anatomy.—Merely that of the complications and a catarrhalinflammation of the respiratory tract. SYMPTOMS.—The presence of a marked coryza, injected conjunctivae,photophobia, and indications of slight fever may be the only signs noted at theonset and by their intensity the first, second and third always suggest the truecause in the case of children. Chill or decided chilliness is not common. Fever.—The fever rises steadily, reaching its maximum (103 to io5°F.)with the appearance of the exanthem (fourth day). Its subsidence begins asthe rash commences to fade, and the normal is attained, either by crisis orthrough a lysis occupying from two to four days. The Rash.—Kopliks spots appear early in 90 per cent., and the mucousmembrane shows the eruption before the skin is affected.
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c ..2 0 ■5Q 0 s .24 MKASLKS 1067 These may be present from two to four days before the appearance of theexanthem ami appear first opposite the molar teeth as pearly gray (not whiteor yellow) spots, smaller than the head of a common pin, cadi lying usuallybut not always within a red aureola. Later they may extend to the inner surface of the lips, occur more widelydistributed on the surface of the buccal mucous membrane and even onthe soft palate. When present in large numbers, the whole surface involvedis reddened and the discrete appearance of the spots is lost. They havethen become a multitude of gray dots on a red congested background.They disappear as the body rash develops. The appearance of the true spots should be carefully studied inasmuchas somewhat similar lesions have been reported in other contagious diseases,and furthermore because of their great importance in early diagnosis. A t the end of the third or during the fourth day, and at the height of the fever,the general r

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