There’s Nothing Small About Smallpox

Posted by on Feb 7, 2014

 

The Course of the Disease

 

You can prevent smallpox, but there’s no cure: once you got it, there was no stopping it. Note the past tense and celebrate. Here’s what you’re missing:
 

Before the Rash

Symptoms of headache, high fever and sometimes vomiting appeared like a thunderclap. On or around the third day, the rash began to appear.
 

Red Rash Rising

  • Tiny red flecks appeared and rose into bumps. At this stage, smallpox was easily confused with measles.
  • The rash seemed to flow from the face downwards, becoming thickest on the face and extremities.
  • This stage lasted about 3 days.

 

Blisters

  • The bumps became blisters said to feel like BB pellets under the skin.

 

Pocks

  • The blisters enlarged to “pocks” filled with thick yellow pus.
  • It felt like being sheeted in flame.
  • The pocks gave off a rotten stench: doctors could diagnose the disease by smell alone.

 

  • The center of each pustule showed a small depression like a bellybutton.

 

Concentration

  • Pocks might number in the hundreds or even thousands.
  • They usually remained separate, with patches of normal skin still visible.

 

Scabs

  • About 10 days after the rash first appeared, the pustules began to scab.
  • 3 or 4 days later, the scabs began to fall off, leaving deep pitted scars called pockmarks.
  • At first, pockmarks were brown on light-skinned people and pale or white on dark-skinned people. The color might fade with time, but the pits were permanent.
  • A victim remained contagious until every last scab was gone.

 


This child’s pocks are scabbing on face and arms, but still in the pustule stage on the legs. Pocks tended to be thickest on the face, arms and legs.
 

Three Forms of Smallpox

The most common form of this grotesque disease (pictured on this page) was once known as “Discrete” or “Distinct” smallpox. Other forms, caused by the same virus, were rarer but also more lethal:

 

All About Smallpox: Next

Unfortunately for Lady Mary…

 

All photos on this page: J. B. Byles, from Thomas Francis Ricketts, The Diagnosis of Smallpox (London, 1908).

 

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