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THE PHILIPPINE 
~ JOURNAL OF SCIENCE 
Vor. I MAY, 1906 No. 4 
THE HISTOLOGY OF THE SKIN LESIONS IN VARICELLA.! 
By E. E. Tyzzer.? 
Although varicella is generally regarded as a disease of childhood, the 
following report deals entirely with the skin lesions in adults. These 
cases were observed among adult male Filipinos, inmates of Bilibid 
Prison, at Manila, P. I. 
Concerning the prevalence of this disease in the Islands, I could obtain 
but scanty information. In some localities it is recognized by the natives 
as a distinct disease and is called in the Tagalog “buluton tubig” or 
waterpox, to distinguish it from “buluton” or smallpox. In one of the 
provinces a native boy who showed the characteristic eruption of varicella 
was met, with his face pitted from a former attack of smallpox. 
The occasional occurrence of varicella in adults is generally accepted, 
although some eminent authorities claim never to have seen a case. 
Thomas (15) (16) states that he never saw a case in an adult and that 
eruptions resembling varicella in adults indicate variola. Von Genser 
(6) has analyzed 29,250 cases of varicella and finds that 98.22 per cent 
occurred before the fifteenth year of life and 1.78 per cent between the 
fifteenth and sixty-first year. Race, climate and confinement in crowded. 
prisons doubtless contribute to make adults more susceptible to this 
disease. In the cases dealt with in this paper the diagnosis was definitely 
established by inoculation experiments and by the histological study of 
the skin lesions as well as by the clinical features of the disease. 
It was formerly a matter of controversy whether variola and varicella 
were etiologically identical and but different manifestations of one and 
the same infection. Hebra and certain others of the Vienna School have 
* The work on which this paper is based was carried on in the Biological Labor- 
atory of the Bureau of Government Laboratories at Manila. It was undertaken 
in connection with an investigation upon smallpox which Dr. W. R. Brinckerhoff 
and I were carrying on at the time. I am indebted to Dr. Brinckerhoff for many 
valuable suggestions and for the interest which he gave to this work. The oppor- 
tunity for this study of varicella was afforded through the courtesy of Dr. Moulden, 
physician to Bilibid Prison. Funds were furnished by a grant of two Bullard 
Fellowships. ’ : 
*K. E. Tyzzer, M. D., Assistant in Pathology, Harvard Medical School. 
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