. The treatment of disease : a manual of practical medicine . tty degeneration. Symptoms. The disease occurs in three types: (o) Fario/a I^ra, of which two forms are described, i. Discrete. 2. Con-fluent. {b) Variola hcBmorrhagica, of which two varieties have been Purpura variolosa or black smallpox. 2. Variola hmmorrhagica pusiu-losa or pustular haemorrhagic smallpox. 254 THE INFECTIOUS DISEASES. (c) Varioloid or smallpox as modified by vaccination. (a) Variola vera. In the discrete form the period of incubation is fromseven to fifteen, usually twelve days. During this period ther
. The treatment of disease : a manual of practical medicine . tty degeneration. Symptoms. The disease occurs in three types: (o) Fario/a I^ra, of which two forms are described, i. Discrete. 2. Con-fluent. {b) Variola hcBmorrhagica, of which two varieties have been Purpura variolosa or black smallpox. 2. Variola hmmorrhagica pusiu-losa or pustular haemorrhagic smallpox. 254 THE INFECTIOUS DISEASES. (c) Varioloid or smallpox as modified by vaccination. (a) Variola vera. In the discrete form the period of incubation is fromseven to fifteen, usually twelve days. During this period there are rarely anyprodromata, but at its end the invasion of the disease occurs suddenly withone or more chills. In children a convulsion is a frequent initial are headache backache (which is characteristically intense), andgeneral pains with nausea and vomiting and prostration. The temperaturerises rapidly to 103° to 104° F. (° to 40° C.) on the first day, the pulse israpid and tense and nervous symptoms may be manifested; even delirium. Fig. 10.—Clinical chart of smallpox showing fall in temperature upon the appearanceof the eruption and its rise upon the incidence of the stage of pustulation. may be present in severe infections. The skin is usually hot and dry, but incertain instances marked sweating may occur. The severity of the initialsymptoms is no indication of the type of the disease. About the second day the initial rash appears. It may be either dififuseand scarlatiniform or macular; while the eruption may be general it usuallyoccurs only upon the lower abdomen, the sides of the chest, in the axillaryregion, and upon the inner aspects of the thighs. Haemorrhagic petechisemay accompany them. The scarlatinal type is the more frequent. Initialeruptions are by no means the rule, since they appear in only from ten tosixteen percent of patients. About the fourth day the characteristic eruption of the disease appears,first upon the forehead along the e
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