*Varicella.*--In varicella the stage of invasion is usually much
shorter than in smallpox, the prostration less marked, and the lumbar
pains of the latter disease are absent. The eruption in varicella comes
out in successive crops and runs a shorter course, so that lesions in
various stages of development may be seen side by side. The temperature
does not necessarily fall on the appearance of the eruption, and there
may be a more or less marked rise with each fresh crop of vesicles, the
temperature curve presenting thus a remittent character. The eruption
itself presents marked differences in the character and the course of
the individual lesions, as well as in their distribution. The clear
vesicles shoot up from the surface, as it were, without warning; or
there may be for a brief period only a circumscribed erythema like
that which usually precedes the appearance of an urticarial wheal.
The vesicles of varicella have usually a somewhat obtusely conical
shape, while those of smallpox are distinctly hemispherical. The
characteristic umbilication of the smallpox vesicle is wanting in
varicella. It is true the varicella vesicle often shows a depression
at its apex; but this false umbilication, as it is called, is due to
the rupture of the vesicle and the escape of some of its fluid or to
a partial drying of its watery contents, and occurs only after the
vesicle has existed for some time. The vesicle of varicella appears
much more superficial in its seat, and its roof is much thinner, so
that it ruptures readily. Very moderate pressure with the finger
suffices to break it. When ruptured in this way the vesicle usually
collapses completely, contrasting in this respect with the smallpox
vesicle, from which, owing to the multilocular character of the lesion,
all the fluid does not escape.
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