I490 



COSMOPOLITAN FEVERS 



Sign or Symptom. 



Chicken-pox. 



Smallpox^. 



Initial symptoms . . 

 Temperature 

 Situation of rash . . 

 Vesicles 



Absent as a rule, but may 

 resemble smallpox. 



Does not fall with the 

 appearance of the rash. 



Most marked on the 

 trunk. 



Develop in twelve to 

 twenty-four hours; are 

 rarely umbilicated ; col- 

 lapse on pricking; all 

 stages.papules, vesicles, 

 and flattened scabbing, 

 puckered pocks, appear 

 together. 



Usually well marked, but 



may be absent. 

 Falls with the appearance 



of the rash. 

 Most marked on the face 



and limbs. 

 Papules hard and shotty; 



are slow in developing; 



vesico-pustules are more 



commonly umbilicated; 



eruption more uniform, 



and the scabbing margin 



is not puckered. 



From Measles. — The diagnosis from measles may be made as follows: — 



Sign or Symptom. 



Measles. 



Smallpox. 



Catarrhal symptoms 



Filatow or Koplik's 



spots 

 Eruption 



Temperature 



Lachrymation, coryza, 

 cough present from the 

 beginning and marked . 



Usually present. 



Appears on the third to 

 fourth day as minute 

 pink papules behind 

 the ears, on the fore- 

 head, chin, cheeks, 

 neck, limbs, and chest. 

 Papules not hard or 

 shotty. 



Reaches its height with 

 the appearance of the 

 rash. 



Usually absent, but there 

 may be some conjunc- 

 tival effusion. 



Absent. 



Initial measly eruption on 

 the first or second day 

 on face, trunk, and 

 limbs simultaneously. 

 If partial, appears in 

 the abdomino - crural 

 area. Papules hard and 

 shotty. 



Falls with the appearance 

 of the rash. 



From Influenza, etc. — In German measles the initial severe symptoms are 

 absent, and in the fourth disease the face is free, while in influenza the typical 

 eruption fails to appear. 



From Typhus. — 'The diagnostic features are: — 



Sign or Symptom. 



Typhvis. 



Smallpox. 



Erythema . . 

 Typical eruption . . 



Appears on the third to 

 fourth day of the illness . 



Petechial. Appears on the 

 fourth or fifth day, and 

 is rarely seen on the 

 face. 



Appears on the first or 

 second day of the illness. 



Papulo-pustular. Appears 

 on the third or fourth 

 day, and is common on 

 the face. 



