ACUTE INFECTIOUS DISEASES. 



other. These cases show that vaccination during the period of incuba- 

 tion of small-pox cannot cut short the disease, and also that the sus- 

 ceptibility to vaccination is not lost during the period of incubation. 

 To avoid vaccinating persons who are already in the inclibation stage 

 of variola, it is well for a physician to vaccinate without delay all of 

 his patients, where he considers the operation necessary, as soon as he 

 knows of the appearance of small-pox in the vicinity. Inoculated 

 small-pox generally runs a milder course than that due to infection, it 

 is true ; but the exceptional cases where the inoculated variola runs 

 a malignant course, and ends fatally, are still so numerous that at pres- 

 ent we should not think of inoculation, as we have vaccination to rely 

 on. Besides vaccination and revaccination, we should not be deterred 

 by any personal considerations from exercising the most stringent rules 

 for the isolation of small-pox patients, even if they should be very an- 

 noying for the patient and his friends. 



The treatment of small-pox can only be symptomatic, as we know 

 of no remedy for cutting short the disease, and averting dangerous 

 accidents. In the prodromal stage the patient should be kept mod- 

 erately cool, the temperature of his room should be about 60, the bed- 

 covers should not be too heavy ; we should not dose him with warm 

 tea, but let him have cold water or lemonade, absolute diet, and, where 

 there is constipation, we may order enemata of three parts of water to 

 one of vinegar. If the prejudices of the patient render it necessary to 

 give some medicine, we may order a solution of nitre. Even in severe 

 congestion of the head, with a full pulse, we should avoid bleeding, 

 which was formerly so popular in inflammatory small-pox, and limit 

 ourselves to the application of cold to the head, and repeated ablutions 

 of the body with cold water. The administration of camphor and other 

 remedies, for causing derivation to the skin and hastening the eruption, 

 formerly so much in vogue, is very objectionable. During the eruptive 

 stage we should especially attempt to prevent the development of a 

 severe eruption on the conjunctiva. This may be done by the assidu- 

 ous employment of cold water compresses, or, still better, by com- 

 presses moistened with a weak solution of corrosive sublimate (gr. j to 

 water vj). Cold and the mercurials are also much used for the pre- 

 vention of deep destruction of the skin, and disfiguring cicatrices. For 

 this purpose it is best to cover the face (which is the only part usually 

 protected) with a mercurial plaster, emplastrum de vigo, and to leave 

 it on for several days. Skoda prefers compresses moistened with solu- 

 tion of corrosive sublimate (gr. ij iv to water f vj) to mercurial plas- 

 ter, which induces an injurious elevation of temperature. Hebra re- 

 jects both mercurial plaster and solution of corrosive sublimate, as 

 well as collodion, and touching the individual pocks with nitrate of 



