and in protecting the exposed skin after the
inoculation. If the vaccination "takes," a certain amount of
inflammation follows, the spot on the arm suppurates, the suppuration,
however, disappearing at the end of about three weeks. If this does not
occur, that is, if the vaccination does not take, it may be either
because the vaccine was not good or because of the unsusceptibility of
the person. In the largest proportion of cases, however, the difficulty
is with the vaccine or with the doctor who does the inoculating, and
when smallpox is prevalent in the vicinity a person should be
re-vaccinated until the vaccination does take. The disease itself, while
disagreeable, is not as hopeless as was formerly thought. There is no
particular heroism in being physician or nurse to a smallpox patient
now, inasmuch as vaccination absolutely prevents contraction of the
disease, and the isolation practiced is the most serious objection from
the standpoint of the attendants.

_Characteristics of smallpox._

The disease first shows itself as does measles and scarlet fever, with
the appearance of a severe cold accompanied with a high fever. On the
second day a rash resembling that of measles and scarlet fever breaks
out on the body; this preliminary rash almost immediately disappears and
is followed by the real characteristic smallpox eruption, usually about
the fourth day. This eruption appears first on the forehead or face and
then on the other extremities, the hands and feet.

In mild cases, it is very difficult to distinguish between smallpox and
chicken pox, and the only safe measure is to consider all cases of
chicken pox in adults to be smallpox, as they probably are, since the
former disease almost never attacks grown-up people. The pustules which
form in smallpox are first hard and red, and then two or three days
later they are tipped with little blisters which later fill with pus and
appear yellow. About the tenth day of the eruption this yellowish matter
exudes, forming the scar or scab which later dries up and falls off.
Often this eruption is accompanied by excessive swelling of the face, so
that the eyes become closed, it is impossible for the patient to eat,
high delirium prevails, and the task of the nurse in such cases is an
unenviable one. Although usually the pustules are separate and distinct,
sometimes in severe cases they run together, so that the hands and face
present one distorted mass of suppuration and cru