latter and in mild cases does not reappear, but in severe forms the temperature remains about 100 deg. F., and when the eruption is at its height again mounts to 103 deg. to 105 deg. F., and gradually falls with convalescence. The eruption is most marked on the face, hands, and forearms, and occurs less thickly on the body. It appears also in the mouth and throat and when fully developed on the face gives rise to pain and considerable swelling and distortion of the features, so that the eyes are closed and the patient becomes frightfully disfigured and well-nigh unrecognizable. Delirium is common at this time, and patients need constant watching to prevent their escape from bed. In the severe forms the separate eruptive points run together so that the face and hands present one distorted mass of soreness, swelling, and crusting. In these, pitting invariably follows, while in those cases where the eruption remains distinct, pitting is not certain to occur. A still worse form is that styled "black smallpox," in which the skin becomes of a dark-purplish hue, from the fact that each pustule is a small blood blister, and bleeding occurs from the nose, mouth, etc. These cases are almost, without exception, fatal in five to six days. The patient may say that the eruption was the first symptom he observed. This was particularly noticed in negroes, many of whom had never been vaccinated. The eruption may exhibit but a dozen or so points, especially about the forehead, wrists, palms, and soles. After the first four days the fever and all the disagreeable symptoms may subside, and the patient may feel absolutely well. The eruption, however, passes through the stages mentioned, although but half the time may be occupied by the changes; five or six days instead of ten to twelve for crusts to form. In such cases the death rate has been exceedingly low, although it is perfectly possible for a person to contract the most severe smallpox from one of these mild (and often unrecognized) cases, as has unfortunately happened. Smallpox occurring after successful vaccination resembles, in its characteristics, the cases just described, and unless vaccination had been done many years previously, the results are almost always favorable as regards life and absence of pitting.