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\csicular  condition,  and  ina\-.  I  believe,  be  the  source  from  which 
auto-infection  nia)^  become  general. 
A  day  or  so  after  the  first  outbreak  of  \-esicles,  fresh  vesicles  are 
formed  between  the  older  ones,  and  fresh  spots  continue  to  appear 
for  a  week  or  so. 
.V  few  of  the  spots  suppurate  slightly,  but  definite  adherent 
scabs  are  rare.  A  vesicle  may  show  umbilication  when  a  fine  hair 
emerges  from  its  centre. 
The  temperature  is  raised  early,  and  before  any  suppuration  has 
appeared,  and  there  is  no  ‘  secondary  ’  fever. 
Constitutional  symptoms  are  definite  but  slight,  and  no  more 
than  would  be  expected  to  accompany  the  moderate  degree  of  fever 
iisuall}'  present  (100°  to  I02°F.),  and  which  lasts  for  a  few  days 
only.  Itching  is  not  generally  a  marked  symptom,  and  is  usuall)- 
not  present  till  the  later  stage  ;  it  is  rarely  intense,  and  it  msually 
ceases  before  the  rash  has  entirely  disappeared. 
The  face  may  be  attacked  but  usually  less  so  than  other  parts  ; 
the  palms  of  the  hands  and  soles  of  the  feet  usually  escape  ;  the 
fingers  show  few  if  any  spots.  Disappearance  of  Ihe  rash  with 
desquamation  of  the  epidermis  of  the  affected  parts  is  slow  and 
protracted,  and  even  with  frequent  bathing  and  friction  the  skin 
may  still  show  signs  of  the  rash  for  a  month  or  six  week,  or  e\'en 
longer.  No  pitting  or  discoloration  is  found  afterwards.  The 
mucous  membranes  are  not  usually  affected  though  I  have  seen 
spots  on  the  prepuce  and  glans  penis.  The  progress  of  vaccination 
is  not  influenced  by  the  disease. 
