This section is from the book "The Home Hand-Book of Domestic Hygiene and Rational Medicine. Volume 2.", by J. H. Kellogg, M.D.. Also available from Amazon: The Home Hand-Book of Domestic Hygiene and Rational Medicine, Volume 2.
The patient should be kept quiet in bed. Should be given but very little simple, easily digested food. He may be allowed to take cool or cold water, lemonade, etc., at pleasure. The sick-room should be well ventilated, and should be kept at a temperature of 60° or 65°. As the disease cannot be broken up or interrupted in its course by any known remedy, the thing to be aimed at in treatment is to carry the patient safely through the ordeal, and to aid nature in the process of eliminating the poison with which the system is struggling. The high fever which occurs previous to the eruption, should be relieved by means of large cool compresses laid upon the body, and changed as often as they become warm, together with cool sponging. The wet-sheet pack renewed every fifteen or twenty minutes until the fever is lessened, is a very efficient remedy. When the face is flushed and the headache severe, ice compresses or ice bags should be applied to the head. If there is much vomiting and retching, the patient should swallow small bits of ice. Ice compresses should also be applied about the neck when the throat symptoms are severe.
The burning and itching of the eruption is best allayed by means of cold compresses, which should be changed as often as they become warm. If the odor is very bad, a lotion composed of an ounce of carbolic acid, one-half pint of glycerine, and two pints of water, may be applied two or three times a day. The solution should be well shaken each time before it is used. It has the effect not only of correcting the bad odor, but also to allay itching of the skin. Frequent inunction of the whole body with vaseline or sweet oil should be practiced once or twice a day.
When the scabs are formed, and are coming off, the patient should take a warm bath twice a day. Various plans have been adopted for the purpose of preventing "pitting." One of the most common, and probably quite as effective as any, is that invented by the ancient Arabian physicians, which consists in letting out the contents of each pustule by a fine needle passed under the skin a little ways from the edge of each vesicle. Touching the pustules once or twice a day with tincture of iodine is also well recommended as a means for preventing pitting. Another remedy recommended by some physicians is keeping the patient in the dark; but this plan is not a good one, as the deprivation of sunlight has a bad effect upon the course of the disease. Keeping the face covered with cotton well soaked in carron oil, a mixture of equal parts of olive oil and lime water, is also an excellent measure to prevent pitting; but the mixture has a bad odor, and is gummy and disagreeable. Covering the face with a thick layer of starch paste is excellent for the same purpose. None of these plans are entirely successful, however, and simple inunction of the skin, and the continuous application of the cold compresses, are probably as effective as any measures which can be employed. Adding a little soda to the water in which the patient is bathed, will facilitate the separation of the hard crusts which form near the conclusion of the disease.
The old-fashioned sweating process in which the patient was smothered beneath heavy blankets, and kept in a highly heated apartment de prived of fresh air, and still further heated by stimulating drinks, cannot be too strongly condemned. This method of treatment is a relic of the Dark Ages. There are no grounds whatever for fear that the eruption will be driven in by the proper application of water, even at quite a low temperature. Care should be taken, however, that the patient is not exposed to drafts, although there is much less danger of taking cold even from this source than is generally supposed.
Some years ago we saw an account of a patient who became delirious while undergoing treatment by the old-fashioned method, and while the attendant was absent for a few moments, threw himself out of the window into a snow-bank, where he was found by the attendant upon his return. The result, instead of being disastrous as might have been supposed would be the case, was in the highest degree favorable; the exposure to cold having the effect to diminish the fever in such a degree that the patient pretty soon became conscious, and made a good recovery.
Some years ago, when practicing in connection with one of the dispensaries in New York City, we had ample opportunity for observing the tenacity with which the ignorant classes cling to the old idea that fresh air is fatal to small-pox. In one case, we found a little boy suffering with the worst form of the disease, lying in a crib unconscious, dressed in the same clothing in which he had been taken sick four or five days previous, and almost stifled with the foul and heated atmosphere of the unventilated room. Notwithstanding our most earnest appeals for fresh air for the little patient, the parents insisted on keeping the windows and doors tightly closed. The little fellow survived, notwithstanding, but that he did not die was certainly not due to the efforts of his parents in his behalf.
It is now pretty well settled that the disease cannot be averted nor mitigated by vaccination after exposure, even though it be performed immediately.