The Fargo forum and daily republican. [volume] (Fargo, N.D.) 1894-1957, 1911-09-08
SMALLPOX THAT
Is not SMALLPOX
NORTH DAKOTA MEDICAL MAN
WRITES THE FORUM REGARD
ING THE DISEASE or SMALL
Pox AND SAYS CERTAIN DIS
EASE IS WRONGLY DIAGNOSED.

4 Verona, N. D., Sept. s,-To The For
UNI: ! have no desire to step into the
iimelight, but wish to have you give
space in your valuable paper with its
more tnan statewide circulation to a
matter OF public health. AS it is
| matter concerning the public as well
/ as the medical fraternity prefer the
| Wlder publicity of a metropolitan pa
per to the restricted one of the med
| ical journal.
| About once in two years there sweeps
over the state an epidemic which is
characterized roughly by an initial
FEVER and an eruption of pimples and
a cry Of smallpox from the people
among whom the disease appears.
which cry is echoed by the physician
| called to view the case
For the benefit Of him who reads
will quote from the greatest Of Ger
man authorities, DR. Abraham Jacob.
OF Freiburg, in Breisgau, and ]. J.
Pringle M. M. r. r. G. p, physician
to the department for diseases OF the
skin at the Middlesex hospital, Lon
don.
Smallpox is an extremely infectious
unknown; 1t is, however very resistant
and is capable of communicating the
malady bEt directly and Indirectly
After a period OF incubation ranging
from ten days to q fortnight. severe
general symptoms manifest themselves.
especially high temperature, backache
delirium, vomiting and swelling of the
| spleen. Then a prodromal rash APP
xNyNt rI4 a..
matous or haemorrhagic spots occur
ring chiefly on the abdomen and inner
sides OF the thighs; this diminishes
In few days at the time the fever
and general symptoms decrease. Now
the characteristic eruption appears,
first on the scalp and face, then on
the trunk, arms and leg in the form OF
small red nodules which increase in
number and size, and develop into
vesicles with clear contents. AS the
temperature again rises the contents
of the vesicles become cloudy, a little
depression or umbilication forms I'm
their center and the postules, which
may either remain discrete or run to-
gether surrounded by red zone, rep
resent the acme OF the eruptfon's de-
velopn1ent or maturation. The rash
is especially abundant and continent |
on the face and hands, but the mucous |
membranes--especially the conjunc-
tivae-may also be involved At this |
stage serious nervous disorders and |
internal complications occur which |
gravely imperil the patient.
In favorable cases the inyolution
OF the eruption begins in from twelve
to fourteen days, with some fall Of
temperature. The postules dry up and
form crusts, which separate In three
or four weeks, leaving red scars when
the process may be considered at an
end, although the period OF infection |
lasts for some tins longer. In less
favorable cases the epidermic covering
OF the yesicles is shed, and extensive
pustulating surfaces are exposed, while
the general symptoms remain severe.
Continent and hemorrhagic small
pox must always be regarded as spe-
cially virulent forms which generally
end fatally. Milder forms with scanty
eruption or abortive cases In which
the rash is arrested in the earlier
stages Of it's development, runs a
shorter course, with less severe gem
eral symptoms.
Apart from the above mentioned
nervous disorders and internal com
plications others may arise especially
secondary infections, and these may
cause death by general sepsis, or ex-
tensive soaring and the loss Of one
or both eyes.
"The diagnosis, which Is often ex-
tremely difficult In the earlier stages
or, indeed, scarcely possible, becomes |
easy when the rash with its typical
pustules is fully developed. Ii
THE differentiaI diagnosis must be | ,
from other infectious dis
eases, more especially from pustular
syphilis, but the latter always shows J
other specific manifestations on close {
examination. In every case one must /
ascertain Ii the patient has been re- I
,ently vaccinated and IL he has been !
exposed to the danger of contagion. !
IN chickenpox the general condition is ]
lot so grave, the prodromal eruption /
md the qualification Of the vesicles 3
ire not present; and different stages /
If development of the eruption are al :
most always present at the same time" I
A review of the statement by q Z
recognized authority puts !
hese points in the foreground. viz:
4
Ind swelling Of the spleen. A rash !
IN the abdomen and inner sides OF !
he thighs. Al disappearance Of the 4
ever when this rash appears. The :
appearance OF the red spots which i
'orm vesicles The modification or :
iimpltng in the tops Of the vesicles I
which become pustules. And q return !
II the fever, and general nervous !
symptoms. Nothing is said OF shotty 4
Eases in the red spots. Of which so /
much Is made by our medicine men. I
In fact, by both the public and the :
physician smallpox is commonly looked !
lpon as being a disease in which a !
snap diagnosis can be easily made,
while the great German authority says :
hat the diagnosis is not easily made
Until the characteristic eruption APP
bears which are (a) vesicles, OBJ UNI
,ilication, (cl pustulation. The second
ever is also one OF the earmarks OF !
his pestilence.
Now for the typical case OF the epi-
lemic which infests this state and
'ther near parts OF the west: A mod
.rate fever, a backaclae, q severe head :
lche. The appearance OF pustuIes
after which the fever falls and patient
eels fine during the remainder OF his (.
rouble. The pustules dry up In from !,
seven to eight days. and the scabs
almost Immediately peal orr leaving /
! pink surface with In very rare cases
! scar.
/ leave your intelligent readers to
iraw their own conclusions as to
whether or not the dread disease small
INV g0n@ YeAr{nd4n 80 ~ IN rv III. t~fess ~, 4