1492 



COSMOPOLITAN FEVERS 



3. There is no secondary fever in children. 



4. Though Jenner's vaccine is in some degree protective, the disease can 

 occur after recent successful vaccination. 



^ ^. Jenner's vaccination can be successfully carried out shortly after an 

 attack of alastrim. 



6. According to some authorities, an attack of smallpox does give a lasting 

 immunity to alastrim. 



Provisionally we may conclude that it is probably a slightly different form 

 of disease from true variola. 



Symptomatology. — It begins with high fever, severe pains, and vomiting, 

 with very often delirium. The rash comes out on the third day, when the 



Fig. 680. — Alastrim. (After Ribas.) 



temperature descends, the symptoms disappear, and the patient feels so well 

 that he may resume his ordinary avocations. Secondary fever is usually 

 absent, especially in children, but may occur about the eighth day. Papules 

 become pustules and scabs, and these drop off, leaving little scarring, but 

 only pigmentation. 



Complications. — -Haemorrhagic cases are unknown. 



Mortality. — The death-rate is remarkably low, about i to 2 per cent. 



Prophylaxis.— The usual isolation, quarantine, and vaccination of contacts 

 and cases must be adopted. 



