Chapter 4 - Skin Diseases
Introduction to Skin Diseases
Congestive Inflammation of the Skin
Scarlet Fever
Smallpox Vaccination
Smallpox Illustration
Smallpox Variola
Chicken Pox
Image of Erysipelas & Inflammatory Blush
Cow Pox
Nettle Rash
Rose Rash
Inflammatory Blush
Watery Pimples
Eczema and Salt Rheum
Mattery Pimples
Crusted Tetter
Papulous Scall
Scaly Eruptions
Dry Pimples
Warts and Corns
Mother's Marks
Nerves of the Skin
Color of the Skin
Disorders of the Sweat Glands
Disorders of the Oil Glands and Tubes
Barber's Itch
Disorders of the Hair and Tubes
Gypsy Moth and Brown Tail Moth
Red Nose

4.7 Smallpox Variola

Small Pox. Variola.

THIS is another disease characterized by acute inflammation of the entire skin, both external and internal, connected with infectious and contagious fever. The eruption has the form of red points, which soon become pimples, then vesicles, then flattened and scooped out vesicles, then pustules, and finally hard brown scabs. These last fall off from the eleventh to the twenty fifth day, and leave behind them small pits and scars. The fever is remittent, and precedes the eruption some three or four days, ceasing when the eruption is developed, and returning when it has reached its height. The period between exposure and the attack of the disease, called incubation, is from five or six to twenty days, being short in the severe cases, and longer in the milder ones.

Symptoms. The disease begins with languor and lassitude, with shivering, and pains in the head and loins; with hot skin, and quickened pulse and breathing; with thirst, loss of appetite, and furred tongue; with nausea, vomiting, constipation, restlessness, and universal prostration. To these symptoms sometimes succeed difficult breathing, cough, drowsiness, and even insensibility. The tongue, white at first, soon becomes red at the point, and over the whole surface. The fever is highest during the night. The constitutional symptoms are more violent just before the eruption, but immediately subside, and soon disappear, when the breaking out is established. The eruption is at first in the shape of small red points, which are hard to the touch, and shaped like a cone, and are proportionate in number to the subsequent pustules. In PLATE 11 the artist has well exhibited the developed disease, as well as the progress of the eruption from day to day.

Treatment. Like the two preceding diseases, the ordinary, uncomplicated form of this requires only the most simple treatment. Not much is wanted, except confinement in bed, cooling drink s, cool and even temperature, frequent change of linen, and sponging the body with cool water. But when what is called the fever of invasion is past, and the eruption is fully developed, and has brought along with it the secondary fever, then some recipe, as (131), (355), (125) will be in place, and some gentle laxative to keep the bowels open (8), also gentle injections (249), and opiates to relieve sleeplessness and nervous symptoms; (356) (357) may be used if very sleepless.
Should the system, at this period, appear to be sinking, a more generous diet, and a little wine may be allowed. If the brain suffers, apply cold ice cloths to head, or an ice bag behind the ears, and put the feet in a mustard bath (242) If the breaking out appears with difficulty, put the patient into a warm bath, and give extract of jaborandi (358): Gargles will frequently be needed for the inflammation, and dryness of the mouth and throat (243). Cold sponging may be considered as highly beneficial, in both the primary and secondary fever. The belladonna likewise is a useful remedy, used in the same way as in scarlet fever. The plaster (288), applied to the face, will, it is said, arrest the formation of matter, and prevent the unsightly scars which so often cover the face of persons who have suffered from small pox. Paint the face once or twice a day with glycerin, which will effectually prevent pitting. The use of flexible collodion is better.

To avoid Pitting, and the occurrence of unsightly scars of the face, several methods of dressing have been used. The simplest consists in covering in the vesicle with iodoform collodion, say, twenty grains of the former to one ounce of the latter. Having pricked the vesicle with an absolutely clean needle, one, for instance, that has been boiled in soda water for five minutes, a layer of this collodion should be applied and allowed to dry on at once. Should pus form under this coating it must be released by washing off the collodion with alcohol. The wound is then to be thoroughly disinfected with carbolic acid water (one teaspoonful to pint of water) and the collodion again applied.
THIS process will avoid most of the pitting.

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