A PRACTICAL TREATISE ON SMALLPOX

Note.—The names of the colored plates are in capitals. The letters H., P., and F. in brackets indicate that the cases were photographed by Hubbard, Pollitzer, or Fox.

This shows the earliest eruption upon back and buttocks. The photograph was taken about seven hours after its first appearance. The patient was sent to Riverside Hospital, where she developed hemorrhagic smallpox, and died on the fourth day. [H.]

Showing numerous incipient papules upon the face. Those upon the forehead were the first to appear and are most prominent. The cheeks present a characteristic leathery appearance. [H.]

Showing upon the face and cheeks a form of the disease commonly known as “black smallpox.” Figs. 1 and 2 were photographed on the second day and show a profuse and dark eruption. The swelling and disfigurement of the face present a most striking appearance. Figs. 3 and 4 were photographed on the fourth day, when the patient was in a moribund condition. [H.]

A case of moderate severity, with well-developed vesicles and characteristic grouping of lesions upon the face. [P.]

Fig. 1 shows a mixed eruption of papules and vesicles upon the right thigh. (Third day.) This condition is exceptional in Variola, though quite common in Varicella. [F.] Fig. 2 shows well developed umbilicated vesicles upon the forearm. (Fifth day.) [H.] Fig. 3 shows a hemorrhagic effusion into the vesicles on the thigh and leg, a condition far less serious than the purpuric eruption of malignant variola. [P.]

These illustrations show a partly confluent character which the eruption frequently presents, even in mild cases, and especially upon the legs. The influence of pressure in developing a more profuse eruption may be noted above the ankles, where shoes were laced, and below the knees, where garters were worn. [F.]

Fig. 1 shows umbilicated pustules with an intense œdema of the foot, considerably increasing its size and causing much pain. Fig. 2 shows the epidermis raised in a large, irregular patch by the confluence of pustules. [F.]

Fig. 1 shows an eruption discrete upon the trunk and even upon the hand, while confluent upon the forearm. [H.] Fig. 2 shows a vaccine pustule coexisting with variolous pustules. The vaccination took place before the disease began, but too late to exert a decided prophylactic effect. [P.] Fig. 3 shows an eruption of large, flaccid pustules with swelling of the foot. [P.] Fig. 4 shows an eruption of discrete, tense, hemispherical pustules. [F.]

A typical case of mild smallpox occurring after vaccination and sometimes called Variola modificata or Varioloid. [P.]

A severe case, showing the characteristic aggregation of lesions on the face and extremities. [P.]

These illustrations show the pustular lesions in the stages of complete distention, when they present a rounded appearance, and of incipient desiccation, when they appear flattened and with a central depression or “secondary umbilication.” [P., F., F.]