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58
a depression in their centre, but this disappears as the rash gets
older Each vesicle is also usually surrounded by an inflamed border.
About the eighth or ninth day of the illness the vesicles begin to dry
up, and are converted into scabs, which fall off about the sixteenth
day of the illness, leaving in most cases a series of pock marks on
different parts of the body. The patient is infectious from the
beginning of the illness until all scabs have disappeared from the
body.
Measures to be Adopted in Order to Prevent the Spread
of Small-pox.
Vaccination.—This is a means of the first importance, both
during and between epidemic periods. The value of it may be
measured from the following quotations from the report of the
Royal Commission on small-pox.
The Commissioners report:—
(1) That it (Vaccination) diminishes the liability to be attacked by the disease.
(2) That it modifies the character of the disease and renders it (a) less fatal, and
(b) of a milder and less severe type.
Every child should be vaccinated not later than six months after
birth, if its health permits; and in order to obtain a continuance of
the protection afforded by this operation should be revaccinated about
the age of 11 or 12 years
The degree of protection may be estimated from the character of
the vaccination marks. On this point the Royal Commissioners
report: ''We think it may fairly be concluded that where the vaccine
matter is inserted in three or four places, it is more effectual than
when introduced into one or two places only—and that if the
vaccination marks are of an area of half a square inch, they indicate
a better state of protection than if their area be at all considerably
below this."
During the Prevalence of Small-pox:—
(1) Immediately a person is suspected to be suffering from smallpox
he should be strictly isolated until medical opinion has decided
the nature of the complaint.