Variola, vaccination, varicella, cholera, erysipelas, whooping cough, hay fever / by H. Immermann [and others] ; edited with additions by John W. Moore ; authorized translation from the German, under the editorial supervision of Alfred Stengel.
- Immermann, H.
- Date:
- 1902
Licence: In copyright
Credit: Variola, vaccination, varicella, cholera, erysipelas, whooping cough, hay fever / by H. Immermann [and others] ; edited with additions by John W. Moore ; authorized translation from the German, under the editorial supervision of Alfred Stengel. Source: Wellcome Collection.
59/730 (page 49)
![smallpox scars, remain permanently on the skin as remains of the pre- vious intense local process. Before the introduction of vaccination, these formed the majority of all cases of smallpox in tnost epidemics, although with all imaginable degrees of intensity. Now they occur mostly in those who have not been vaccinated or in whom revaccination has not been at all or not well attended to. From variola contluens, the simple variola vera (or discreta) is distinguished by the fact that in this form there is no or only a slight blending of the individual smallpox eihorescences in the stage of suppuration, as well as that only small, round discrete scars are left. Among all the forms of smallpox, variola vera is especially characterized by the duration of the period of eruj)- tion and the manner in which the exanthem is usually distributed over the skin, and, most of all, by a typical behavior, so that on this account it deserves to be first mentioned in this description. Period of Eruption and Development (Efflorescence).—Symptoms ill the Skin and JIucous Membranes.—The eruption, which usually begins toward the end of the third day of sickness (compare the earlier statements) genemlly advances slowly in variola vera and lasts usually about three days. Hence it is evident that in the regular form of the disease about six days intervene between the beginning of the initial stage and the time when the smallpox efflorescences are distributed over the whole surface of the body. The period of development of the rash following its first eru])tion—that is, the period of conversion of the original papules into vesicles with clear contents—usually consumes two days, after which, on about the eighth day of the disease, suppuration of the pocks begins. The manner of distribution of the smallpox exanthem over the sur- face of the body in variola vera is especially characteristic, in so much that its anatomic topography is far more regular than in the other forms of smallpox. The face and head are almost always attacked first; then, gradually descending, the trunk, and last the extremities, so that the variolous poeks in the three regions named appear respectively on the first, the second, and the third day of the period of eruption. Subsequent batches of spots may appear in the regions already attacked during the three days, but they are not numerous, and usually none appear after the end of the characteristic time of the general eruption. At this time, toward the end of the sixth day of illness, the whole surface of the patient’s bo<ly is more or less thickly covered with discrete pocks, which become vesicular oii the face and head wliile tliose on the rest of the body are still papidar. ii—4](https://iiif.wellcomecollection.org/image/b29012090_0059.jp2/full/800%2C/0/default.jpg)
