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- Herausgeber: Science & Technology Publishing
- Kategorie: Geisteswissenschaft
- Sprache: Englisch
A Practical Treatise on Smallpox is a comprehensive medical work authored by Dr. William Woodville, first published in the late 18th century. This seminal volume offers an in-depth exploration of smallpox, a devastating and highly contagious disease that shaped the course of human history. Drawing on his extensive experience as a physician at the Smallpox and Inoculation Hospital in London, Dr. Woodville provides a detailed account of the symptoms, progression, and varieties of smallpox, including the distinctions between the confluent and distinct forms. The treatise meticulously examines the methods of prevention and treatment available at the time, with particular emphasis on the practice of inoculation—a precursor to modern vaccination. Dr. Woodville discusses the efficacy, risks, and controversies surrounding inoculation, presenting case studies and statistical observations to support his arguments. The book also delves into the history of smallpox, tracing its origins and spread across continents, and considers the social and ethical implications of disease management. Written in clear, accessible language, A Practical Treatise on Smallpox serves as both a scientific resource and a historical document, reflecting the medical knowledge and public health challenges of its era. It remains a valuable reference for historians of medicine, epidemiologists, and anyone interested in the evolution of infectious disease control.
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Veröffentlichungsjahr: 2025
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Transcriber’s notes:
In this transcription, hyperlinks (to pages and illustrations) are identified by black dotted underlining, and also by aqua highlighting when the mouse pointer hovers over them. A red dashed underline marks a concealed comment that can be revealed by hovering the mouse pointer over the underlined text.Page numbers are shown in the right margin.
A short table of contents has been inserted to assist readers.
The following spelling errors have been corrected silently: pathognomic → pathognomonic accidently → accidentally coalesence → coalescence hematomesis → hematemesis hemorraghic → hemorrhagic uniformily → uniformly
APRACTICAL TREATISEONSMALLPOX
LIST OF ILLUSTRATIONS.
Note.—The names of the colored plates are in capitals. The letters H., P., and F. in brackets indicate that the cases were photographed by Hubbard, Pollitzer, or Fox.
PLATE
This shows the earliest eruption upon back and buttocks. The photograph was taken about seven hours after its first appearance. The patient was sent to Riverside Hospital, where she developed hemorrhagic smallpox, and died on the fourth day. [H.]
Showing numerous incipient papules upon the face. Those upon the forehead were the first to appear and are most prominent. The cheeks present a characteristic leathery appearance. [H.]
Showing upon the face and cheeks a form of the disease commonly known as “black smallpox.” Figs. 1 and 2 were photographed on the second day and show a profuse and dark eruption. The swelling and disfigurement of the face present a most striking appearance. Figs. 3 and 4 were photographed on the fourth day, when the patient was in a moribund condition. [H.]
A case of moderate severity, with well-developed vesicles and characteristic grouping of lesions upon the face. [P.]
Fig. 1 shows a mixed eruption of papules and vesicles upon the right thigh. (Third day.) This condition is exceptional in Variola, though quite common in Varicella. [F.] Fig. 2 shows well developed umbilicated vesicles upon the forearm. (Fifth day.) [H.] Fig. 3 shows a hemorrhagic effusion into the vesicles on the thigh and leg, a condition far less serious than the purpuric eruption of malignant variola. [P.]
These illustrations show a partly confluent character which the eruption frequently presents, even in mild cases, and especially upon the legs. The influence of pressure in developing a more profuse eruption may be noted above the ankles, where shoes were laced, and below the knees, where garters were worn. [F.]
Fig. 1 shows umbilicated pustules with an intense œdema of the foot, considerably increasing its size and causing much pain. Fig. 2 shows the epidermis raised in a large, irregular patch by the confluence of pustules. [F.]
Fig. 1 shows an eruption discrete upon the trunk and even upon the hand, while confluent upon the forearm. [H.] Fig. 2 shows a vaccine pustule coexisting with variolous pustules. The vaccination took place before the disease began, but too late to exert a decided prophylactic effect. [P.] Fig. 3 shows an eruption of large, flaccid pustules with swelling of the foot. [P.] Fig. 4 shows an eruption of discrete, tense, hemispherical pustules. [F.]
A typical case of mild smallpox occurring after vaccination and sometimes called Variola modificata or Varioloid. [P.]
A severe case, showing the characteristic aggregation of lesions on the face and extremities. [P.]
These illustrations show the pustular lesions in the stages of complete distention, when they present a rounded appearance, and of incipient desiccation, when they appear flattened and with a central depression or “secondary umbilication.” [P., F., F.]
In Fig. 1 an occlusion of the nasal passages is indicated by the lips parted in respiration. [P.] Fig. 2. shows a palmar condition which, in the adult, is found only in smallpox. [P.] Fig. 3 shows the desiccation of the facial eruption in advance of other regions. [P.] Fig. 4 shows a mild discrete case in which a diagnosis of acne had been made. [F.] Fig. 5 shows the eruption in the stage of desiccation. [F.]
Showing a few thick crusts remaining upon the face with numerous dull red spots from which the crusts have fallen. [F.]
Figs. 1 and 3 show the dried pustules remaining in the thickened skin of palm and sole after the crusts have fallen elsewhere. [F., P.] Fig. 2 shows the superficial desquamation which follows the falling of the crusts, producing rings of partly detached epidermis. [F.]
Fig. 1 shows a peculiar pigmentation sometimes left after the eruption. The central portion, being darker, produces a “bull’s-eye” appearance. [F.] Fig. 2 shows the hypertrophic condition of the scars which occurs in certain cases in place of the usual pitting, and which tends to disappear in time. [H.] Fig. 3 shows severe pitting, a partial loss of hair and eyebrows, and destruction of one eye. [H.]
Fig. 1 shows the typical appearance of a successful revaccination. (Fourth day.) [F.] Fig. 4 shows a small, well-formed vaccination pustule at its height. (Eighth day.) [F.] Fig. 2 shows a large, irregular pustule resulting from scarification of an area of unnecessary extent. (Eighth day.) [F.] Fig. 5 shows an ulcer resulting from infection of the vaccination lesion. [F.] Fig. 3 shows a primary vaccination at its height (eighth day) with a characteristic areola. [F.] Fig. 6, a case of Varicella on the third day. [F.]
PREFACE.
Whenever a physician is called to a case of suspected smallpox, he confronts a grave responsibility. If young or without special experience, he is apt to feel a sore need of assistance, and, although a book can never take the place of an experienced consultant, it is the object of the present work to render him as much aid as possible. The text aims to be practical rather than elaborate. The plates are reproductions of photographs from life, some of which have been obtained under great difficulty.
While many articles on variola have been illustrated by a few photographs of cases, mostly of the pustular type, this work is believed to be the first which has presented illustrations of the smallpox eruption in each of its successive stages. It is sincerely hoped that the reader will find it of service in familiarizing him with the peculiar features of the disease.
GEORGE HENRY FOX.
SMALLPOX.
CHAPTER I.
SYMPTOMS AND COURSE.
Variola, or smallpox, is an acute, contagious disease, characterized by an eruption upon both the skin and mucous membrane, with constitutional symptoms of greater or less severity. The eruption presents successively a macular, papular, vesicular, and pustular stage, the pustules finally drying into crusts, which fall and leave the skin temporarily discolored. Where ulceration has occurred it is permanently scarred or pitted. The lesions of the mucous membrane appear upon those parts more or less exposed to the air,—the mouth and eyes, for example,—but in exceptional cases they may be found throughout the entire intestinal tract, and in the uterus and bladder. These lesions do not run a course similar to those observed upon the skin, but appear as red macules, which rapidly change into ulcerations, covered with a whitish pellicle. The ulcers are imbedded in the substance of the mucous membrane and are not as superficial as in cancrum oris. The constitutional symptoms are most prominent during the periods of invasion and pustulation.
There are various clinical forms of smallpox, which may be conveniently described as (1) discrete, (2) confluent, and (3) hemorrhagic, or malignant; and then, according to intensity, as (a) very mild, (b) mild, and (c) severe. The few purpuric spots seen in the severe discrete and the confluent forms are not of great significance, as they are generally due to a peculiar diathesis, and as a rule the patient recovers. The malignant form is almost invariably fatal.
The term discrete implies that the lesions are separate and distinct, not coalescent. If the lesions coalesce and form patches of various shapes and sizes, the eruption is called confluent. For the purpose of differentiating the various forms above mentioned, it is convenient to first trace a normal, unmodified case of smallpox from the initial symptoms to recovery, and then to consider the severe forms, and finally the rare and obscure forms of the disease.
Period of Incubation.—This extends from the date of exposure to the occurrence of clinical symptoms, a period usually lasting from twelve to fourteen days.
Period of Invasion.
