eruption is the characteristic feature of this
disease, and it is so well distinguished that there is no danger of
failing to recognize it. It is not common in grown people, and while it
should not arouse suspicion in children, it is so uncommon in adults
that a suspected case is probably a mild case of smallpox, and should
always be quarantined as such.

With children, the accompanying cold and fever is often very mild, so
that the appearance of the rash is the first and only symptom of the
disease. The eruption is a progressive thing, each day's crop coming to
full bloom and dying out as the next day's crop develops. This is, by
the way, a distinguishing characteristic of this disease,
differentiating it from smallpox where the pustules are more persistent
and where the breaking out is more general. The pustules are sometimes
extremely irritating, and it is very hard to keep children from
scratching, the results of which may leave deep scars and so should be
avoided. An antiseptic ointment should be used as with scarlet fever and
measles, carbolized vaseline being suitable, although sometimes a strong
solution of soda is substituted. It is not common to disinfect in
chicken pox to the same extent as in the other diseases, the contagion
being apparently in the air rather than in clothing and short lived. In
New York State, in 1908, no deaths are recorded from chicken pox, and it
is because of this lack of fatal results that the disease is regarded so
indifferently and no particular pains taken to prevent its spread.

CHAPTER XIX

_PARASITICAL DISEASES (MALARIA, YELLOW FEVER, HOOKWORM, BUBONIC PLAGUE,
AND PELLAGRA)_

_Malaria._

From time immemorial, malaria (or fever-and-ague) has been one of the
great plagues of humanity. No advance outpost of civilization but has
suffered, more or less severely, from this disease. Dickens, in one of
his novels, describes graphically the disease as it existed in the early
American settlements, and vividly portrays its ravages, both mental and
physical, among the pioneer settlers. Certain sections of the world have
been especially noted for the prevalence of this disease, making
extensive regions practically uninhabitable. The vicinity of Rome, with
its swampy marshes and low-lying areas, has been one of these plague
spots. The jungles and swamps of the equator and the coastline of Africa
and South America and the valley lands of the Mississippi River have all
been noted