and is surrounded by a large area
of redness. From the eleventh day the vaccination sore dries, and a
brown scab forms over it about the end of the fourteenth day, and the
redness and swelling gradually depart. At the end of about three weeks
the scab drops off, leaving a pitted scar or mark. Not infrequently
the vaccination results in a very slight pimple and redness, which
passes through the various stages described, in a week or ten days, in
which case the vaccination should be repeated. Unless the vaccination
follows very closely the course described, it cannot be regarded as
successful, although after the first one or two vaccinations the
result is often not so severe, and the time of completion of the
various stages somewhat shortened.

Rarely an eruption, resembling that at the vaccination site, appears
on the vaccinated limb and even becomes general upon the body, due to
urticaria or to inoculation, through scratching.

The special treatment of an attack of smallpox is largely a matter of
careful nursing. A physician or nurse can scarcely lay claim to any
great degree of heroism in caring for smallpox patients, as there is
no danger of contracting the disease providing a successful
vaccination has been recently performed upon them. The patient should
be quarantined in an isolated building, and all unnecessary articles
should be removed from the sick room, in the way of carpets and other
furnishings. It is well that the room be darkened to save irritation
of the eyes. The diet should be liquid: milk, broths, and gruels.
Laudanum, fifteen drops, or paregoric, one tablespoonful in water,
may be given to adults, once in three hours, to relieve pain during
the first few days. Sponging throughout the course of the disease is
essential; first, with cool water, as directed for scarlet fever, with
the use of cold on the head to relieve the itching, fever, and
delirium. The cold pack is still more efficient. To give this, the
patient is wrapped in a sheet wrung out in water at a temperature
between 68 deg. and 75 deg. F. The sheet surrounds the naked body from feet to
neck, and is tucked between the legs and between the body and arms;
the whole is then covered with a dry blanket, and a cold, wet cloth or
ice cap is placed upon the head. The patient may be permitted to
remain in the pack for an hour, when it may be renewed, if necessary,
to allay fever and restlessness; otherwise it may be discontinued. The
cold spongin