CHICKEN POX. VARICELLA
Chicken pox is an affection almost entirely special to children, in whom it may be observed from their first year, although it is especially frequent from the ages of two to six. It appears often in the epidemical form and spreads by contagion.
Some doctors are inclined to regard varicella as a very attenuated form of smallpox, hence the name "chicken pox," by which it is popularly known. This opinion is based merely on the analogy between the two types of skin eruptions and the coincidence sometimes observed between two epidemics of smallpox and chicken pox. But the theory falls on considering that, on the one hand, chicken pox offers no safeguard against infection by smallpox and does not prevent the effects of vaccination, and, on the other hand the disease may occur in children who have been vaccinated or who have had smallpox. Chicken pox, too, differs essentially from smallpox in the course of its development.
After a period of incubation, extending over a fortnight, chicken pox becomes apparent by such symptoms as slight shivering, extreme fatigue and a general but not very intense condition of fever. In less than twenty-four hours small pink spots will appear on the skin, and these after a few hours are topped by a vesicle, and the next day the whole rash shows a vesiculous appearance.
The vesicles are sometimes small and pointed, sometimes more voluminous and globular in form. They are filled with a limpid or a slightly yellowish liquid. Their base is sometimes surrounded by an inflammatory ring. By the third day the contents of the vesicle has become thicker and tends to become purulent. On the fourth day desiccation commences, and the vesicles shrivel and shrink in and form small brownish scabs, which fall about the eighth day. Frequently the child will scratch them off with the finger nails before they are entirely desiccated. The vesicles leave small reddish spots, which generally disappear gradually, almost always without a scar.
An eruption of chicken pox does not burst out all over the body at once, but appears in successive rashes. It is not confined to any special parts of the body. It may begin and spread at the same time from the face, the trunk of the body or the limbs. A dozen pimples may be seen the first day, while three or even ten times as many may be visible the next day, and so on for several days in succession.
Sometimes the vesicles appear on mucous membrane at different parts—the mouth, tongue, soft palate and tonsils—and may also invade the conjunctiva and cornea, or the larynx, where they will set up laryngitis.
Owing to the very contagious nature of chicken pox, the first thing to be done is to provide for the complete isolation during a period of twelve to fifteen days of all patients attacked by the disease.
The treatment of the disease is solely a matter of hygiene. The more severe the fever the stricter the diet should be, and in the case of great fever, the diet should be restricted to broth and milk. If there is no fever the child need not be placed on any special diet.
If the intestines are sluggish, they may be stimulated by administering a dose of castor oil. It is advisable to make the patient rinse his mouth two or three times a day with a mouth wash. It is also well to apply a lotion around the eyes and face, consisting of two per cent. boracic acid solution with the chill taken off. Finally, in order to prevent the child scratching the sores and the consequent danger of inoculation by the finger nails, it is a good practice to rub a small amount of carbolated vaseline over the itching parts. It is frequently found necessary to have the little patient wear white woolen gloves to prevent scratching and infecting the sores. If a child scratches the sores on the face it will leave an unsightly mark which will stay for the rest of its life.
The child, of course, should not be allowed to rejoin his playmates without having had a good bath, and having had his clothes completely disinfected.