The struggle for recognition of the different acute contagious exanthems, though interesting as history, need not take our time except as a reminder of the obstacles and prejudices encountered in the evolution of differential diagnosis. As variola and varicella were separated, so morbilli and scarlatina parted company to stand as distinct entities instead of different manifestations or expressions of one contagium.
There are those who can recall the controversy over the identity of rötheln (German measles), and there may be those who still hesitate to award nosologic dignity to that symptom-complex.
With here and there exceptions, however, the profession has accepted rubella as an entity in the group of exanthems, to our great relief in differential diagnosis.
Morbilli, scarlatina and rubella in their typical forms show individuality beyond question. In hybrid forms and in mixed infections differentiation by mere symptoms alone is extremely difficult and at times impossible.
COTTON AC. SCARLATINA AND DUKES' DISEASE.. JAMA. 1907;XLIX(17):1417–1420. doi:10.1001/jama.1907.25320170007002a
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