This section is from the book "Hartmann's Theory Acute Diseases And Their Homoeopathic Treatment", by Charles J. Hempel. Also available from Amazon: Theory of acute diseases, and their homoeopathic treatment.
During the eruptive as well as the febrile stage, children are frequently attacked with convulsions. These can be speedily arrested by exposing the patient to the influence of a cool, fresh air at the open window; injections of tepid water are likewise useful. If these means should not be sufficient, if the child should be pale, with cold extremities, frequently emitting pale urine, if the symptoms should indicate a purely nervous, spasmodic condition: the patient should be put in a lukewarm bath and should be administered Zincum, third trituration, one dose every hour. If the convulsions should depend upon gastric irritation, the remedies indicated for gastric affections have to be resorted to; if worms should be the cause, the remedies mentioned for worm fever will be found suitable. If the convulsions should be accompanied with sopor, and the patient's face should be bright-red and the forehead hot, Opium is the best remedy.
In the eruptive stage more than in any other, the pocks incline to become malignant by combining with typhoid or putrid symptoms, or to disappear suddenly.
In either case, Arsenic is best calculated to ward off the danger, provided the vital forces be not too much depressed and the organism too much reduced.
After having controlled the eruptive fever, accompanied with violent congestion of the brain, delirium, burning heat of the skin, dryness of the tongue, great thirst, etc., by Belladonna, I have frequently administered, in this stage, the isopathic variolin, by means of which I have succeeded in shortening the course of the eruption and preventing the suppurative fever. Vaccinin has likewise been found useful in this stage, even more so than variolin.*
§ 97. The suppurative stage commences on the fifth, seventh or ninth day. In this stage the pustule completes its development and is surrounded with an areola. The lymph with which the pustule is filled, first shows itself in the tip of the pustule where a little blackish depression is seen, which is termed the umbilicus of the pock. The lymph goes through a variety of changes in colour and consistence, from water-coloured to white and yellow, and from a fluid to a papescent consistence, until it is gradually transformed into a scurf. Isolated pocks are termed variolas discretes. If a number of pocks flow into each other and form one suppurating surface, they are termed confluent small-pox (variolas confluentes). If the pocks be very numerous, the whole body swells, particularly the head and eyes. The mucous membrane of the nose and fauces is inflamed. In many cases a real ptyalism sets in. The fever in the suppurative stage may be more or less violent, according as the pocks are more or less numerous. The higher the fever, the thicker and more turbid the urine, which sometimes exhibits a purulent sediment. In this stage the characteristic small-pox smell is most offensive, and appears intolerable to those who are not constantly with the patient.
* It may not be deemed superfluous to recommend Sulphur as an excellent remedy in this and the next stage; even if it had not the prophylactic virtues which Hartmann supposes it possesses, may it not, in a great measure, be capable of preventing the pitting of the skin? - Hempel.
If the fever be very slight and no other untoward symptoms exist, the patient can do without medicine, and all that is required is to observe the hygienic rules previously indicated. But if the fever be violent, if the nose, throat and eyes be affected and ptyalism have set in, Mercurius is to be administered in repeated doses every two or three hours. Nitric acid, Hepar sulphuris c. and Tartarus emeticus are likewise very useful in the suppurative stage.
Whatever complication may have existed in the previous stages, becomes much more marked in the third stage, inducing either an inflammatory, typhoid or putrid fever.
It may be expedient to open the pustules and to prevent the absorption of the pus. It is likewise useful to drink much water in order to act upon the bladder. The swelling of the face and eyes may be relieved by fomentations with tepid milk. The angina faucium is likewise relieved by injections of tepid milk into the throat.
A sudden desiccation of the pustules and disappearance of the swelling of the face are sure indications of approaching death. In such a case it is sometimes possible to rouse the sinking vital force by repeated doses of Camphor, by washing the body here and there with the spirits of Camphor, applying warm poultices to the hands and feet, and thus establishing an action towards the surface and preventing a metastasis to important internal organs.
If the pocks should turn black and typhoid symptoms should set in, Acidum muriaticum will frequently be found sufficient to restore the chances of recovery. Rhus tox. or Arsenic should be given if the pocks should suddenly fade, with livid areolae, blackish color of the inner mouth, dry, shrivelled tongue, burning thirst, meteorism, great exhaustion.
§ 98. The stage of desiccation and desquamation is the last stage of the disease. It commences with the appearance of a brown point in the centre of the pock. This point is first perceived on the pocks that came out first. The pocks remain longest on the soles of the feet and the hairy scalp. The suppurative fever, the swelling and smell diminish gradually and finally disappear. The patient now experiences a violent itching of the skin. The lymph gradually dries up, and a brown, hard, dry scurf forms, which, on falling off, leaves a new, sound skin and cicatrices, corresponding in size and depth to the suppuration which had been going on in the skin. After this period the skin remains for a long time sensitive to the atmospheric air. All danger ceases as soon as the process of desquamation has terminated in the face. The commencement of the desiccation of the pustules in the face is the most important period of the disease. At this time the greatest number of deaths occur in consequence of putrid decomposition or mortification of the pocks, haemorrhage, inflammation of noble organs, such as the lungs, brain, bowels; or else nervous spasms and convulsions set in.
If any of these conditions should set in, the physician has to prescribe the remedies indicated in their respective places. Otherwise no further treatment is required, except frequent washing with tepid and lastly with cold water, in order to diminish the sensitiveness of the skin.
Among the disastrous consequences of small-pox we may notice the following: disfiguration of the face by cicatrices; destruction of the eyes; chronic ophthalmia, which is frequently cured by Hepar sulph., Digitals, Clematis, Baryt. carb., Sulph., Euphrasia, Lycopo-dium, Rhus t., Arsenicum, etc.; frequently recurring boils in various places, which disappear under the use of Euphrasia, Thuja, Belladonna (Sulphur, Nitric acid, Phosphorus, etc., being the best remedies to remove the disposition for their recurrence.) The caries which frequently occurs after small-pox is combatted by Asa, Silicea, Mezereum, Aurum, Nitric ac, etc. For the remaining consumptive affections, the reader is referred to the chapter where these diseases are specially treated of.