Evening star., 1898-12-31
Timely Topic Discussed by Promi-
nent Physician.
PEOPLE SHOULD Be ON THEIR GUARI
Difficulty in Distinguishing Disease
From Chickenpox
NECESSARY PRECAUTIONS

The presence of smallpox for some time
past at Norfolk, Va, its more recent ap-
pearance at Hancock and Hagerstown. Nd.
and the report of two cases within the past
few days al Alexandria, Va, render it
not improbable that some cases of that
disease may find their way into this Dis
trict, so that, in the opinion of a prominent
physician with whom a Star reporter today
talked, it behooves the public and the med
ical profession to be on their guard against
it, and to adopt whatever measures may
tend to lead to the early isolation of every
case, if any appears,
The law itself requires he said that
every case which may resemble smallpox,
or that immediate diagnosis cannot be
made, shall BE- isolated as if it were small
pox as long may be necessary to de-
termine its nature. The experience of many
other communities is instructive in this par
ucuiar. Because of the supposed absence
of smallpox from the community and the
mild type of the disease as it first appear
ed (and a mild type seems to prevail gem
orally throughout the country, the first
cases have been diagnosed by the families
in which they have occurred-and in some
instances by physicians who have been
called in to see them-as chickenpoX, and
1t has not been until the subsequent occur
renee Of seyerer cases and after the
disease has gained foothold that its true
nature has been recognized.
Difficult to Diagnose.
So difficult is the diagnosis between chick
enpox and smallpox, when the latter oc-
ours in mild form, that some cities are
now requiring the report of all cases of
chickenpoX and isolating them as well as
small poX, thus cutting the gordan knot
IN heroic manner. but in this community,
Where any such action must depend upon
legislation by Congress, the differentiation
OF chickenpoX from smallpox must rest
with the medical profession 1t is folly
Tor the laity at such time as the present
to undertake to diagnose such diseases and
IN view of the facility with which the poor
can obtain medical advice from the phy-
slcians appointed for that purpose-for no
suspicious case should ever be sent to a
ulspehsafy or hospital-poverty affords no
excuse for neglect
Every member of the community has it.
ZOO IN his power to render himself prac-
ucaiiy immune against smallpox by yacci-
nation. Despite all that has been said
against this method statistics which are
above criticism show concIusiyely that vac
cinauon does afford protection certainly
for limited period-probably not less than
HVe years But in view of the fact that so
long as previous vaccination protects an
individual against smallpox q SUBSEQUENT
vaccination will not take those who have
been Vaccinated, although they may believe
themselves immune. should definitely de-
termlne this question by being revaccinatetl
If they are immune to smallpox they will
not suffer any inconvenience from the
operation. while if they are not immune
any slight Inconvenience to which they may
be put will be amply repaid by the i'm
munity against smallpox which will be con-
ferred.
Matter Of Vaccination
1T is not safe. however to rely on the
result of a single vaccination if unsuccess-
fti, but the operation should in such cases
be. repeated several times before a person
regards himself immune Many,
though possibly not all, of the unpleasant
results which have been attributed to vac
cinauon have been due to the faulty per-
formance of the operation, and some to
defective vaccine matter. There is less
danger from the first than formerly, be-
cause of better knowledge on the part
of the medical profession of the PRINCIPLES
of surgical cleanliness, and less danger
from the latter because of improvements in
the method of producing and storing vac
cine lymph. The vaccinations which result
after the use of glycernated vaccine lymph
are almost uniformly less severe than those
which formerly occurred from the use of
the lymph dried on ivory points.
Smallpox Symptoms.
The first symptoms of smallpox ordi-
narily occur in from twelve to fourteen
days alter exposure to the disease. The
onset is usually sudden and accompanied
by viol=At rigor or a series of rgors;
fever sets i: Immediately and may be high;
vomiting usually occurs and is commonly
severe; headache and backache are con-
Stant and extreme. The above SymptonlS
do not, however, always appear in typical
form and some of them may be absent The
eruption usually appears on the third or
fourth day about the forehead or face
spreads rapidly to the body and limbs, and
is especially marked about the hands and
feet The points of eruption may number
but one or two or be sufficient TO cover the
entire body. The important point TO be re-
membered, however, is that the disease
may be very mild and resemble chicken
pox, or that chickenpoK may be rather
severe, especially when it appears in an
adult, and resembles smallpox. so that the
citizens should be on their guard if they
would avoid an outbreak of this disea Sc. >,