Identifier: amerbook00star (find matches)
Title: An American text-book of the diseases of children ..
Year: 1895 (1890s)
Authors: Starr, Louis, 1849-1925 Westcott, Thompson Seiser, 1862-
Subjects: Children
Publisher: Philadelphia, W.B. Saunders
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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and varies in intensity with the severity of the attack. The child becomesrestless and there is mild or active delirium. The temperature ranges from101° to 104° F., with morning remissions and evening exacerbations. Thepulse is quick and hard. Often the symptoms assume the typhoid type, withlow delirium or stupor, a rapid, feeble pulse, and subsultus tendinum. A tem-perature that frequently rises above 104° during the stage of suppuration isof grave significance. (See Fig. 1). The stage of desiccation or decline begins on the twelfth or thirteenth dayof the disease. The pustules begin to dry up, the inflammation and swellingof the skin subside, the temperature gradually falls, and there is a generalimprovement in all the symptoms. Many of the pustules rupture and the 186 AMERICAN TEXT-BOOK OF DISEASES OF CHILDREN. exuded contents form discrete or coalesced crusts. Cicatrization goes on under-neath the crusts, and they finally drop off, leaving dark, violaceous blotches that Fig. 1.
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Temperature Chart of Variola of Moderate Severity. are gradually changed to white, irregular, depressed cicatrices. The wholecourse of the disease occupies from three to five weeks. Based upon the distribution and amount of the rash, variola is classifiedinto— (1) Discrete variola, in which the rash is scanty and the individual lesions aremore or less separated from one another by healthy skin. The disease is rarelydangerous to life, its symptoms are mild, and its course is often interruptedbefore the development of the pustular stage. The secondary fever is absentor of short duration. (2) Confluent variola, which is marked by an eruption that covers almostthe entire cutaneous surface and invades the mucous membranes with greatseverity. The pustules upon the hands and face run together, so that theepidermis is raised by a milky, sero-purulent secretion; on other parts of thebody the eruption is more or less discrete. The invasion stage is severe, andthe rash appears as early as the

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