An accute infectious disease characterized by pronounced skin eruptions. The eruptions have four stages: papule, vesicle, pustule, and crust. When the crust forms, it comes off, leaving a pit in the skin. In confluent types of the disease the scar is most pronounced, sometimes destroying otherwise good features.

Etiology

Smallpox is considered one of the most virulent of contagious diseases, and it is generally believed that persons exposed are almost invariably attacked, unless protected by vaccination. This is one of the most stupendous exaggerations to be found in medical literature. My experience has been that very few people take it when exposed to it.

I remember quite a number of years ago being connected with a pest-house, where I was appointed physician and spent two hours a day with confluent smallpox for three months, without taking the disease. It is true I had a vaccination scar from childhood, but I have long since given up the opinion that that afforded me any protection. With me in that epidemic was a thirteen-year-old girl, who was caught and held there by the health authorities. She waited upon the sick people, and in all that time did not spend one hour outside of the house except in the small yard. She never had been vaccinated, and she failed to contract the disease. I could give many instances of personal experience where many were exposed without a single development. In this particular epidemic two German nurses took down, in spite of the fact that they had been vaccinated and re-re-vaccinated in the old country, where they do the work "just right."

Age

The disease is common to all ages, and is very fatal to the extremely old and young. The unborn child may be attacked, but only when the mother develops the disease. It is said that in the case of twins only one may be attacked, thus showing that there is an immunity without vaccination.

Race

It is said that the aboriginals suffered terribly from smallpox. Why? Because it is a disease of filth. The uncivilized people are just filthy enough to be good subjects for this disease. It is said that, when it was first introduced into America, the Mexicans died by the thousand. They yet suffer very greatly. Only a few years ago I was corresponding with a physician, located in Mexico, whose function was to take care of the miners for a large corporation. He gave me much information in regard to the severity of the disease among the natives. It is said the North American Indians have been decimated by this disease. The negroes are especially susceptible, and the mortality among them is great, being about forty-two per cent, against twenty-nine for whites.