ACUTE INFECTIOUS DISEASES. 



and partly perhaps to the inflammation of the scalp causing hyper- 

 semia of the brain. Delirium is more apt to occur in those who 

 have previously been drinkers. A stage of great excitement is often 

 followed by one of weakness with feeble heart-action, which may 

 end fatally. 



As the pocks dry up the parts around become pale and less swol- 

 len, and the patients are again recognizable ; the inflammatory pain 

 gives place to excessive itching, and probably many of the resulting 

 cicatrices may be due to scratching. 



Small-pox has numerous complications, such as bronchitis, pneu- 

 monia, pleurisy (often with purulent effusion), diseases of the larynx, 

 meningitis, uterine haemorrhages, abortions, and affections of the eye 

 and ear. 



Some observations seem to show that the protection from vacci- 

 nation does not begin till twelve or thirteen days after the opera- 

 tion ; but it should be resorted to even after exposure, in hopes it 

 may at least render the course of the disease milder. Inoculation, 

 which was formerly in vogue, usually induced very light cases, but 

 deaths sometimes occurred. 



It is a question how long a patient convalescent from small-pox 

 continues to produce contagion, and how long he should be isolated. 

 He should be isolated till the stage of desquamation is entirely 

 past say fourteen days after the disease is over. 



Dr. Waters, in the London " Lancet," says if sun-light be ex- 

 cluded from the room, the disease is arrested at the papular or 

 vesicular stage, and the pain, itching, and smell are less annoying. 

 Constant applications of emulsion of bitter almonds seem to have 

 the same effect. 



3. P. 654. 



If the fresh dejections of a typhoid patient spread the contagion, 

 persons immediately about him would be most apt to contract the 

 disease, but this does not seem to be the case ; so the stools proba- 

 bly undergo some change which render the germs in them more 

 active. Some authors believe that typhoid may develop spontane- 

 ously, others that it is always due to contagion ; the poison from 

 the patient reaching some place favorable to its development, and 

 thence again entering the human body. 



Most epidemics of typhoid begin after the heat of summer, when 

 the soil is dried to the greatest depth ; but others occur indepen- 

 dently of the time of year or of the dryness. Their extent is usually 

 limited, perhaps to a town or one part of a city, or perhaps to a single 

 house, in which case it must be referred to infected drinking-water 



