§ 100. Spurious small-pox, Varicella.

Varicella is very similar to small-pox, from which it is distinguished by its more rapid course, its benign character, and the absence of the characteristic smell. It frequently makes its appearance at a period when small-pox is prevalent. It runs an irregular course, is very mild and without danger, and is never violent except when the patient is very sensitive and the eruption is complicated with other diseases. Varicella generally lasts from three to seven days, is generally first seen on the face, and is accompanied with a moderate remittent fever, or else there is no fever at all. Sometimes the fever is accompanied with catarrhal symptoms. The eruption appears variously modified.

Varicella does not require any medical treatment. If fever be present, give a little Aconite. In many cases this disease sets in with symptoms of great nervousness, without thirst or general heat of the body, some parts feeling burning hot, others having the natural temperature, and others again being rather cool; these symptoms are attended with restlessness, anxious sleep disturbed with dreams and starting; small children will cry constantly. This group of symptoms is generally relieved by Coffea, or else by Chamomilla, Jalappa, Antim. cr., etc.

During the period of dentition the foregoing symptoms, in consequence of the complication with the fever of dentition, frequently increase to spasms. These spasms are sometimes relieved by Chamomilla, but more frequently by Ignatia and Belladonna, by the latter more particularly when the children are unable to keep their heads erect and rest them on something; when the head and hands feel burning hot, the little patients are very restless, cry a good deal, bend double constantly as if tormented by colic, and when the alvine evacuations intermit. If, under these circumstances, Belladonna be not given in season, encephalitis may set in, or else an effusion may take place, which may terminate in serous apoplexy. If the spasmodic symptoms predominate, Ignatia deserves a preference over Belladonna.

The course of simple and uncomplicated varicella is very much shortened by Pulsatilla, which is likewise an excellent prophylactic against this disease.

The varieties from varicella to small-pox are very numerous, and their boundaries cannot well be defined. Varicella is sometimes found complicated with other eruptions, where the pocks have a livid colour and bear a close resemblance to black small-pox, with violent fever, the intensity of which is by no means proportionate to the number of the pustules. I have seen two cases where varicella was complicated with pocks that assumed a malignant character on the second day of their appearance, had a livid colour, and where the parts round the pock were inflamed and swollen. The fever which accompanied the eruption, requires the administration of Aconite; but Arsenic is required for the desiccation of the pustule.