Treatment.—Vaccinate the children the second or third month, and all persons about every six years, and always after exposure to the disease or during epidemics. Put the patient in a room cleared of all furniture, carpets, curtains, rugs, etc.; keep the patient thoroughly clean, and the linen should be frequently changed. The bed clothing should be light. Disinfect and sterilize everything thoroughly that has been in contact with the patient. Get a good experienced nurse, and one who has been around the disease.
Diet.—Give the supporting diet early. During the first stage give milk, broths of different kinds, albumin water. Relieve the intense thirst by water and lemonade. When the first (initial) fever subsides and the patient feels improved, give milk, eggs, chops, steak, or rare roast meat, bread or toast; vegetables, such as potato, spinach, celery, asparagus tips, cauliflower tops. When the second fever returns go back to the liquid diet again, and give regularly and as much as possible every two or three hours during the day, and every three or four hours during the night. Milk, plain or peptonized; milk punch, raw eggs, broths, beef juice. If swallowing is difficult, give food cold and oftener, and in less quantity. Increase the diet rapidly during convalescence.
Cold drinks should be freely given. Barley water and oatmeal water are nutritious and palatable. Milk broths, and articles that give no trouble to digest.
Nursing.—Nursing is the main thing. The bowels should be kept open with salts. There is no special medicine we can claim will do good. Aconite may be used for the fever at first, in drop doses every hour for twenty-four hours. But the least medicine that is given the better it will generally be.
There is, I believe, something in protecting the ripening papules from the light. The constant application on the face and hands of lint soaked in cold water, to which antiseptics such as carbolic acid or bichloride may be added, is perhaps the most suitable treatment. It is very pleasant for the patient at least, and for the face it is well to make a mask of lint which can be covered with oiled silk. When the crusts begin to form, the chief point is to keep them thoroughly moist, which may be done with oil or glycerin; vaselin is particularly useful, and at this stage can be freely used upon the face. It frequently relieves the itching also. For the odor, which is sometimes so characteristic and disagreeable, the diluted carbolic acid solutions are probably the best. If the eruption is abundant on the scalp the hair should be cut short. During, convalescence frequent bathing is advisable. It should be done daily, using carbolic soap freely in order to get rid of the crusts and scabs. There is danger to others as long as the skin is not smooth and clean, and not free from any trace of scabs. As you must have a physician, I give but little medical treatment. Nursing is the main thing in this disease.
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General Rules for Disinfection.—The walls, woodwork, and ceiling may be cleaned by washing with one to one thousand solution of corrosive sublimate solution, or a five per cent carbolic acid solution, Or by rubbing with bread if solutions would injure. All dust must be removed. Plastered walls and ceilings may be white-washed. Woodwork must then be scrubbed with soap and thoroughly wiped. Then fumigate, at least three pounds of sulphur should be burned in the room for each 1,000 cubic feet of space. Placing it in a pan supported in another containing water to guard against fire. After scrubbing or fumigating, the room and its contents should be freely aired for several days, admitting sunlight if possible. All useless articles and badly soiled bedding should be burned. Such pieces of clothing as will not be injured may be boiled or soaked in a one to one thousand formaldehyde solution (one ounce of twelve per cent solution in one gallon of water), or two per cent carbolic acid solution. Clothing, bedding, etc., may be disinfected in the steam sterilizer.
Hands, Body, etc.—Special outer garments may be worn while in the sick room and removed, and clothing aired before leaving. Hands of the attendant should be washed in one to one thousand corrosive sublimate solution.
Vaccination and Re-vaccination and its Prevention of Smallpox. We quote in part from an article prepared by the State of Michigan. It is well known that smallpox can be prevented or modified by vaccination; and a widespread epidemic of the disease can be attributed only to an equally widespread ignorance or willfulness concerning smallpox and its prevention by vaccination and re-vaccination.
A Good Time to be Vaccinated.—Smallpox is usually most prevalent in the winter and spring months, reaching the highest point in May. The rarity of smallpox in Michigan for several years led to a feeling of security and to neglect vaccination, resulting in an increased proportion of inhabitants not protected by recent vaccination. This made possible a widespread epidemic. The proper preventive of such an epidemic is general vaccination and re-vaccination of all persons not recently thus protected. There is no better settled fact than that vaccination does protect against smallpox. But after a time the protection is weakened, therefore after a lapse of five years there should be re-vaccination.