TEE LATE EFIDEMIC OF SMALLPOX. 559 



settled districts of the further West as far as Idaho, Oregon and Cali- 

 fornia. The sweep of the malady has included individuals of the 

 white race,, the Indians and the negroes, the well-to-do and the poor, 

 the filthy and the cleanl}^, people of all sorts and conditions. If the 

 results had been in any considerable proportion grave, the entire 

 country would have been alarmed, and the attention of all classes con- 

 centrated with a profound interest upon the earliest invasion and prog- 

 ress of the disease in the several localities where it spread. But, for- 

 tunately, the results were mild, so mild, indeed, that the nature of the 

 epidemic, certainly at first, was misunderstood in almost all the places 

 where its victims were discovered. Medical men, well trained in their 

 profession, in many cases could not recognize the nature of the malady 

 by reason of the special features it now for the first time presented. Some 

 physicians, even after demonstration by experts of the character of the 

 symptoms before their eyes, refused to accept the inevitable conclusions. 

 Though obviously a contagious disease and one spreading in epidemic 

 form in an astonishingly large number of villages and towns. East and 

 West, the victims of the disease, because of the very general misappre- 

 hension respecting its nature, were permitted free access to those not 

 affected. In many such centers of population, persons betraying all the 

 external evidences of the disease attended churches, schools and thea- 

 ters; delivered milk, groceries and other provisions at the houses of 

 their customers; officiated in public stations; and even slept in beds 

 occupied by other non-infected members of the same family. A study 

 of the special character of this epidemic possesses interest, because, 

 as a matter of fact, the malady was smallpox. 



The history of smallpox in classical career has been studied with 

 a patient faithfulness and with an attention to every detail that is set 

 forth fully in most of the text-books. Few trained physicians are 

 ignorant of the essential facts thus collated. In the late epidemic 

 visiting this country, confusion in many cases arose from the total 

 failure of the symptoms of the disease to correspond with the classical 

 types previously portrayed in the books and encountered in practice. 

 Almost all the histories of smallpox in the past have been descriptive 

 of epidemics that spread among a people either previously unpro- 

 tected from the disease by modem methods, or through the medium 

 of individuals not so protected. It might, however, have been ex- 

 pected that an epidemic of disease occurring during the last century 

 and another at the beginning of the present, operating on a different 

 soil and under different conditions, would exhibit differences in type. 



That smallpox may be so modified as to be stripped of every one of 

 its formidable features has long been known. The so-called variola 

 sine variolis (smallpox without pocks) is not a fiction of the schools, 

 but a fact of experience. In these instances, after a day or two in 



