As the eruption of smallpox attacks the mucous membrane of the mouth,
nose, and throat, as well as the skin, difficulty in swallowing and
considerable discomfort in breathing is often present, especially
during the suppurative stage. If the patient is able to sit up and
gargle, peroxide of hydrogen or some other antiseptic solution
should be used at regular and frequent intervals. In case of extreme
prostration, when any effort by the patient or the mere raising of the
head might lead to syncope or symptoms of collapse, it is advisable
to wash out the patient’s throat and nostrils with a large swab of
absorbent cotton, dipped in a saturated solution of boric acid.
Pyrozone, borolyptol, listerine, and other liquids may be conveniently
used for this purpose diluted with one or two parts of water. Small
pieces of ice or ice-cream given at frequent intervals with a small
coffeespoon will usually be found extremely grateful to the suffering
patient.
For a purulent conjunctivitis which may sometimes result from the
presence of pustules on the lids, the saturated solution of boric acid
should be frequently used in the form of a spray.
When delirium occurs in this stage the patient must be closely watched,
and, if necessary, the limbs may be kept quiet by linen sheets folded
and carried across the bed and fastened at either end. Since chloral
given by the mouth is liable to cause œdema of the glottis, it may be
advantageously administered by the rectum, or in its place the bromides
or a hypodermic injection of sulphate of morphine may be substituted,
although when the patient is suffering at the same time from severe
bronchitis the use of opium is objectionable.
The treatment of the eruption in the suppurative stage is of the
greatest importance so far as the comfort of the patient is concerned.
A host of applications and peculiar methods of treatment have been
recommended and tested in successive epidemics. Many of these have
been found to have no effect save to intensify the patient’s horrible
appearance and to aggravate his discomfort. From time immemorial
attempts have been made to prevent the pitting of the face after the
disease by treatment of the individual lesions. The cauterization of
the pustules with nitrate of silver after evacuation of the pus--the
so-called ectrotic method--has been practised by many in the past,
but the consensus of opinion at the present day seems to be that the
procedure is as useless as it is painful. The ointments, plasters,
pastes, and varnishes which have also been advocated are usually
unpleasant or troublesome to use, and in the pustular stage are not
likely to accomplish any desirable end. At this period it is too
late to consider the possibility of preventing pitting, although the
resulting injury to the skin may be reduced to a minimum by the use of
all local measures which tend to reduce the grade of inflammation.
Public-domain text, read in full here on John Shaqi.
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