SMALL-PDX ( Varie/a). It is a subject of dispute whether this disease was known to the ancients, or whether it has originated at a comparatively recent date. Those who contend for its antiquity refer us to the account of the plague of Athens by Thucydides (ii. 46, &c.) which, they say, is as accurate a description of the leading symptoms of variola as could possibly be expected from any historian who is not a physician. Those who hold the opposite opinion call in etymology to their aid; the word pock or pox, they say, is of Saxon origin, and signifies a bag or pouch; the epithet malt in England, and petite in France, were added in the 15th century. The term variola is derived from the Latin word runts, a pimple, or varies, spotted; and, according to Moore, the first authentic passage in which it occurs is to be found in the Berti Man Chronicle' of the date 961. The first author, however, who treats expressly of small-pox is Mazes, an Arabian physician [RH/am, in Moo. Div.] but even he confounded it with measles, and these two diseases continued to be considered as modifications Of the same disorder till the time of Sydenham. Small-pox, when it occurs naturally, is preceded by the usual premonitory symptoms of eruptive fevers, such as rigors, pains in the back and loins, prostration of strength, loss of appetite, nausea, and sometimes vomiting, and, in young children, frequently convulsions. About forty-eight hours after the commence ment of these symptoms an eruption of small, hard, red-coloured pimples makes its appearance about the face and neck, and, gradually extends downwards over the trunk and extremities. The primary fever, as it is called, now lessens, but the pimples increase in size, and become converted into whey-coloured pustules with a depression in their centre. On the eighth day they are at their height, and on the eleventh the matter oozes from them and concretes into crusts, which fall off about the fourteenth day, leaving the skin of a brownish-red colour, and studded with alight depressions or pita As the eruption travels from above the parts of the body successively attacked by it become affected with swelling, the mouth waters, and the voice is hoarse; when the incrustation has taken place, these symptoms subside, but a secondary fever commences, which is some time-a more severe than that which preceded the outbreak of the eruption. Smallpox, according to its severity, is distinguished by authors into two varieties, the di.seect and the (affluent, raroola disereta and eamfatne. In the former, the pustules are few in number, well formed, and do not touch each other, and the fever is inflammatory, but mild ; in the latter, the disease altogether is more violent, the eruption more general, and the pustules, small and unhealthy, run one into another. The fever likewise is greater, and rather of the typhoid
character, is not mitigated on the appearance of the eruption, and is much aggravated at its termination ; there is delirium, considerable prostration of the vital powers, ptyalism, inflammation of the Sauces, and frequently hiorelrsao. Petechim and an unhealthy exudation from the body often accompany this form of the disease. Among the mucous membranes, the larynx and trachea suffer much, and children often (lie of suffocation from this cause ; the extent of mucous and of cutaneous inflammation, however, are not always necessarily propor tioned to each other. Small-pox rarely attacks the same individual mere than once, and, like measles and scarlatina, its consequences are sometimes more to be dreaded than the disease itself. During the secondary fever, an intense form of ophthalmia frequently sets in, which rapidly involves all the structures of the eye, and in the course of a few days destroys its entire organisation. Although it is not common to have both eyes thus affected, still a large proportion of the blind at our public institutions owe their misfortune to this disease. Pleurisy, consumption, scrofula, obstinate diarrbma, and a fetid dis charge from the care attended with more or less deafness, are the principal diseases liable to result from a severe attack of small-pox. 'The immediate cause of this disease is a peculiar miasm or poison received into the system from an individual labouring under the same affection, and it is said to make its appearance in from twelve to four teen days after exposure to the contagion ; when, however, it is com municated by inoculation, it appears on the seventh or eighth day. Instances are recorded of mothers who were exposed to the infection of small-pox, communicating the disease to the feetna in utero, without being themselves affected by it; and, what is equally remarkable, women suffering from small-pox during pregnancy, have brought forth healthy children, who did not take the disease till they were inoculated. Smallpox is frequently epidemic, especially in the spring, and, like all other epidemics, those who are first attacked by it suffer the most severely : it is observed also to be greatly influenced by certain con ditions of the atmosphere.