The special treatment of an attack of smallpox is largely a matter of
careful nursing. A physician or nurse can scarcely lay claim to any
great degree of heroism in caring for smallpox patients, as there is
no danger of contracting the disease providing a successful
vaccination has been recently performed upon them. The patient should
be quarantined in an isolated building, and all unnecessary articles
should be removed from the sick room, in the way of carpets and other
furnishings. It is well that the room be darkened to save irritation
of the eyes. The diet should be liquid: milk, broths, and gruels.
Laudanum, fifteen drops, or paregoric, one tablespoonful in water,
may be given to adults, once in three hours, to relieve pain during
the first few days. Sponging throughout the course of the disease is
essential; first, with cool water, as directed for scarlet fever, with
the use of cold on the head to relieve the itching, fever, and
delirium. The cold pack is still more efficient. To give this, the
patient is wrapped in a sheet wrung out in water at a temperature
between 68 deg. and 75 deg. F. The sheet surrounds the naked body from feet to
neck, and is tucked between the legs and between the body and arms;
the whole is then covered with a dry blanket, and a cold, wet cloth or
ice cap is placed upon the head. The patient may be permitted to
remain in the pack for an hour, when it may be renewed, if necessary,
to allay fever and restlessness; otherwise it may be discontinued. The
cold sponging or cold pack are indicated when the temperature is over
102.5 deg. F., and when with fever there are restlessness and delirium.
Great cleanliness is important throughout the disease; the bedclothes
should be changed daily and the patient sponged two or three times
daily with warm water, unless fever is high. Cloths wet with cold
carbolic-acid solution (one-half teaspoonful to the pint of hot water)
should be kept continuously on the face and hands. Holes are cut in
the face mask for the eyes, nose, and mouth, and the whole covered
with a similar piece of oil silk to keep in the moisture. Such
applications give much relief, and to some extent prevent pitting.
The hair must be cut short, and crusts on the scalp treated with
frequent sponging and applications of carbolized vaseline, to soften
them and hasten their falling. The boric-acid solution should be
dropped into the eyes as recommended for measles, and the throat
sprayed every few hours with Dobell's solution. Diarrhea in adults may
be checked with teaspoonful doses of paregoric given hourly in water.
Vaseline and cloths used on a patient must not be employed on another,
as boils are thus readily propagated. All clothing, dishes, etc.,
coming in contact with a patient must be boiled, or soaked in a
two-per cent carbolic-acid solution for twenty-four hours, or burned.
When the patient is entirely free from scabs, after bathing and
putting on disinfected or new clothes outside of the sick room, he is
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