342 ACUTE EXANTHEMATOUS INFECTIOUS DISEASES 



erupt the" temperature becomes normal. The odor of sheep-, 

 pox, which is peculiarly sweetish and nauseating, is quite dis- 

 tinctive. It is most marked in the early stages and often of 

 diagnostic value. 



The eruption also appears in the mucous membranes, pro- 

 ducing when in the mouth, ptyalism; throat, 'dysphagia; 

 bowel, diarrhea, and in the bronchi, cough. 



The following modifications in sheep-pox are observed: 



(a) Abortive, Mild Type. — Either no eruption appears in the 

 skin or only a very few isolated lesions as in "varioloid" of 

 man. The general disturbance is not marked and the course 

 benign. 



(6) No vesicles form, the reddish papules in a few days 

 becoming detached and disappearing. 



(c) Confluent Pox. — This is a more severe form, the pustules 

 occurring very close together and finally blending. It is 

 most marked on the head, the skin of which becomes swollen 

 and may slough; secondary pus infections take place, leading 

 to pyemia and septicemia. There may be severe pharyngitis 

 and conjunctivitis followed by keratitis and blindness. 



(d) Hemorrhagic Pox. — Between the papules dark red 

 blood spots appear which involve the subcutis. Nasal 

 hemorrhage, hematuria, bloody diarrhea and internal hemor- 

 rhage are not infrequent. This form (similar to "black 

 smallpox" of man) is very fatal. 



(e) Gangrenous Pox .—Probably due to a secondary in- 

 fection (necrosis bacillus?) is not a special form but may 

 attend otherwise usual outbreaks. Portions of the skin, and- 

 even the underlying muscle in the region of the eruption 

 become necrotic and slough. 



Complications. — (a) Dermatitis may develop from rubbing 

 and scratching the vesicles, especially in the region of the lips 

 and nostrils. 



(b) Blindness from ulcerative keratitis and later suppura- 

 tive panophthalmia. 



(c) Bronchitis and catarrhal pneumonia. 



(d) Gastro-intes^inal catarrh. 



(e) Suppurative arthritis of the phalangeal joints, shedding 

 of the claws and general pyemia. 



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