The duration of the latent period, the fever, and the infectiveness of the exanthemata, and some allied diseases / by Francis Vacher.

  • Vacher, Francis, 1843-1914.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: The duration of the latent period, the fever, and the infectiveness of the exanthemata, and some allied diseases / by Francis Vacher. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    inoculated smallpox is known to be fully 7 days—Dr. Bristowe says 7 to 8 days. The outside limits of this time in natural smallpox must be set down as from 7 to 21 days. Devia- tions fiom the normal incubation period, except of a day or two, are rare. In many cases where it appears to be pro- tracted to 19 or 20 days, it is probable that the exposure infected the subject's clothes, which subsequently communi- cated the infection. The time from the first precursory symptoms to the beginning of the eruption is difficult to determine, because a physician is rarely by the side of a healthy person to note the first indications of departure from the standard of health. Fortunately for our enlightenment on this point, the pre-eruptive symptoms in smallpox are rational as well as physical; and the main rational symptoms (headaches, pain in the limbs, and lumbar pains) are not likely to escape the observation of the patient. I was thus able in 1877 to obtain the date of sickening and the date of the commence- ment of the eruption of 526 cases. In 17 the first sense of illness was referred to the day on which the eruption began to appear, in 175 to the day before, in 166 to two days before, in 100 to three days before, in 40 to four days before, in 14 to five days before, in 12 to six or seven days before, in one to eight days before, and in one to fourteen days before. Thus 33 per cent of those patients were them- selves sensible of prodromata a day before the eruption began, 31^ per cent two days before, and 19 per cent three days before. I submit, therefore, that the normal duration of the pre-eruptive symptoms is about two days. Its range is probably from a few hours to a week. The time from the beginning of the eruption to the cessa- tion of the pyrexia has no marked hygienic significance, nor is it a matter on which there is much diversity of opinion. For about ten days the fever and pulse go up, and in three or four they subside again. Whether the rash be confluent or discrete makes little difference as to the duration of the fever. From the beginning of the eruption to the resump- tion of the normal temperature we may reckon 14 days. After the temperature and pulse are again normal, the patient may get up ; and the crusts harden and shod. In confluent smallpox this, with the exercise of every care, may be expected to occupy six weeks. In mild cases not less than three weeks should be allowed for it. The normal time from the beginning of eruption till the patient ceases to be