*Period of Eruption.*--With the outbreak of the papular eruption of
smallpox, which usually appears upon the face on the third day of
the disease, a notable decrease of the fever occurs with a decided
improvement in the general condition of the patient. In a mild case,
when a diagnosis of variola is not promptly made, the patient often
returns to his business or pursues his or her customary duties with no
thought of the danger to which others are exposed through contact or
association. But the rapid development of the eruption soon leads to
the discovery of its true nature and a realization of the importance of
continued isolation.
During the papular and vesicular stage little or no internal medication
is required, Gayton, an English writer on smallpox, who evidently
shares the popular belief that the main duty of a physician is to give
medicine, remarks that “we may also prescribe a little effervescing
saline, for unless something is given in the form of medicine, the
impression on the sick man’s mind is that you are doing nothing to
assist him.” An intelligent public, in this country at least, is
gradually awakening to the fact that skilful medical treatment cannot
longer be measured by the number and size of the apothecaries’ bottles.
Although the appetite may now return, a restriction of the diet to
simple and nutritious articles of food, such as milk-toast, eggs,
oysters, and jellies, should be enforced.
The daily bath should be continued, and there is no objection to its
being made antiseptic by the addition of carbolic acid or bichloride of
mercury. It is simpler and safer, however, to employ a plain bath and
to disinfect the skin later by sponging with some antiseptic lotion,
such as peroxide of hydrogen or permanganate of potassium. It has been
claimed by some enthusiast, though never demonstrated, that carbolic
soap will abort the disease.
The local treatment of the eruption during the papular and vesicular
stage has been a subject of experimentation for centuries, and the
prevailing opinion at the present time is that little or nothing can
be done to arrest its development. Most of the local applications,
like the mercurial and other plasters of former days, though doubtless
of some value, have proved generally to be more uncomfortable than
beneficial to the patient. Tincture of iodine, pure or diluted, with
an equal part of alcohol, nitrate of silver solution, collodion,
picric acid, and more recently ichthyol, have been advocated by some
and rejected by others after a careful test of their merits. Gayton
recommends the use of the old itch lotion of sulphur and quicklime when
cases present themselves before eruption or during the papular stage.
He claims that if the lotion is rubbed over the whole body every four
or six hours it will prevent the papules from reaching the pustular
stage and thus avert the severe secondary fever. This surprising
statement he bases on the observation of hundreds of cases.
Public-domain text, read in full here on John Shaqi.
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