o 108 or 109 degrees. The eruption appears on
the abdomen on the third to fifth day.

Treatment like Typhoid.--Mortality, twelve to twenty per cent.

SMALLPOX or Variola.--Smallpox is an acute infectious disease. It has a
sudden onset with a severe period of invasion which is followed by a
falling of the fever, and then the eruption comes out. This eruption
begins as a pimple, then a watery pimple (vesicle) which runs into the pus
pimple (pustule) and then the crust or scab forms. The mucous membrane in
contact with the air may also be affected. Almost all persons exposed, if
not vaccinated, are almost invariably attacked. It is very contagious. It
attacks all ages, but it is particularly fatal to young children.

Cause.--An unknown poison in the contents of the pustules or crusts in
secretion and excretion, apparently, and in the exhalations of the lungs
and skin; one attack does not always confer immunity for life. It is
contagious from an early period. Direct contact does not seem to be
necessary, for it can be carried by one who does not have it.

Symptoms.--Incubation lasts from ten to fourteen days, and is usually
without symptoms. Invasion comes suddenly with one or more chills in
adults, or convulsions in children, with terrible headache, very severe
pain in the back and extremities, vomiting, the temperature rising rapidly
to 103 or 104 degrees.

Eruptions.--This usually appears on the fourth day as small red papules on
the forehead, along the line of the hair and on the wrists, spreading
within twenty-four hours over the face, extremities, trunk and mucous
membrane.

Symptoms of fever diminish with the appearance of the rash, which is most
marked on the face and ripens first there. The papules become hollowed
vesicles and a clear fluid fills them on the fifth or sixth day. They fill
with pus about the eighth day, and their summits become globular, while
the surrounding skin is red, swollen and painful. The general bodily
symptoms again return and the temperature rises for about twenty-four
hours. Drying of the eruption begins the tenth or eleventh day. The
pustules dry, forming crusts, while the swelling of the skin disappears
and the temperature gradually falls. The crusts fall off, leaving scars
only where the true skin has been destroyed.

Confluent form.--All the symptoms are more severe. The eruption runs
together and all the skin is covered.

Varioloid.--This is smallpox modified by vaccination.