. A practical treatise on medical diagnosis for students and physicians . ase may be divided into four stages : (1) incubation,(2) invasion, (3) eruption, (4) desquamation. Incubation. This stage lasts from ten to fourteen days, and is usuallyunaccompanied by any symptoms except, toward its close, by malaise. Invasion. The invasion is abrupt, and is marked by chilliness or adistinct rigor, headache, severe pain in the lumbar regions, and sometimesdelirium or convulsions, especially in children. The most prominentsymptoms are the excruciating headache and backache. The temperatureusually rises
. A practical treatise on medical diagnosis for students and physicians . ase may be divided into four stages : (1) incubation,(2) invasion, (3) eruption, (4) desquamation. Incubation. This stage lasts from ten to fourteen days, and is usuallyunaccompanied by any symptoms except, toward its close, by malaise. Invasion. The invasion is abrupt, and is marked by chilliness or adistinct rigor, headache, severe pain in the lumbar regions, and sometimesdelirium or convulsions, especially in children. The most prominentsymptoms are the excruciating headache and backache. The temperatureusually rises rapidly to 104° F. or higher in the first twenty-four orforty-eight hours. (See Fig. 281.) Headache and backache continue;there are pain in the epigastrium, a coated tongue, loss of appetite, nauseaor vomiting, constipation, and copious perspiration. Prostration is ex-treme. Erythematous eruptions are not uncommon, especially on theinner surfaces of the legs and thighs. Petechia? are found in Simonstriangle, the base of which is at the umbilicus and apex at the Discrete variola on tne The stage of invasion lasts generally three days; but it may be short-ened to two in very severe cases or lengthened to four in very mild ones,and in complicated and hemorrhagic cases it merges into the stage oferuption. (See Plate XIV.) Eruption. The characteristic eruption of smallpox appears first asminute specks resembling flea-bites. These in two or three days developinto small papules which feel like shot under the skin. In a day or two 706 THE INFECTIONS. more the papules become vesicles, at first containing a clear fluid, which,however, rapidly becomes turbid; they are umbilicated. In the courseof another day or two the vesicles have become pustules and are glob-ular in shape. The period of ripening or maturation, when pustulationis at its height, lasts about three days; it is characterized by a markedsecondary fever, the temperature rising as high as, or higher than, in theonset
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