SMALL-POX. 



607 



silver, which have also been recommended. He has come to this deci- 

 sion from the observation in his wards that the pocks do not leave 

 cicatrices any oftener since he has stopped employing these remedies, 

 than when he used them. Hebra applies only cold-water compresses ; 

 while the skill is tense, these relieve the patient, although they cannot 

 protect the skin from destruction. During the eruptive stage, the 

 chief attention should be directed to the fever, for the patient may be 

 much endangered if it become severe. Unless the temperature rise 

 very high, we may abstain from treatment; if it do rise high, we 

 should give large doses of quinine. In the stage of desiccation, we 

 should let the patient have an easily-digestible but nutritious diet, 

 and a little wine ; for the exhausted strength requires building up, and 

 the frequent pulse subsides more readily under the careful supply than 

 under the continued withholding of the nutritive material necessary 

 for the restitution of the body. The patient should be warned against 

 scratching off the crusts, and we should take measures to prevent his 

 doing so involuntarily, while asleep. If the crusts be firmly adherent, 

 and especially if suppuration under them continue, we should employ 

 cataplasms. Among the other symptoms requiring especial attention 

 during variola, are the troubles from the affections of the mucous mem- 

 branes. We cannot hope for an abortive treatment of the pocks on the 

 mucous membrane, except in those in the mouth ; and, even there, as- 

 tringent mouth-washes, and touching the individual efflorescences, are 

 of no material service. If dangerous dyspnoea, and other symptoms of 

 croupous laryngitis occur, we may give an emetic of sulphate of cop- 

 per, and attempt to apply a solution of nitrate of silver through the 

 entrance of the glottis, by means of a probang. In oedema glottidis, 

 if we cannot relieve the patient by scarification, we should perform 

 laryngotomy. Inflammation of the serous membranes, and of the 

 parenchymatous organs during small-pox, may require venesection, 

 especially when, during pneumonia or pleurisy, collateral oedema in- 

 duces difficulty of respiration ; but it should only be employed in cases 

 of absolute necessity, for experience shows that abstraction of blood 

 is badly borne in all infectious diseases. In other respects pneumonia, 

 pleurisy, and other local affections induced by variola, are to be treated 

 according to the rules given when speaking of the primary forms of 

 these diseases. Abscesses of the cellular tissue and suppurating lym- 

 phatic glands should be opened early. 2 



