The usual progress, however, of small-pox modified by vaccination is as follows.  The first stage is the same usually as in the natural form of the disease.  As soon, however, as the eruption appears, the modifying power of the vaccination becomes apparent.  The eruption will be found to be generally both less in quantity and more limited in its extent; or if even it should come out profusely, and cover a large extent of the surface of the body, still the controuling power of the vaccination will immediately show itself after its appearance,—­first, in the complete subsidence of all the febrile symptoms which will now take place; and, secondly, in reference to the eruption, part of which will die away at once, and the remainder will by the fifth day be filled with the opaque yellowish fluid, then dry up, becoming hard and horny, and falling off will leave a mottled red appearance of the skin, and now and then slight pitting.

Such is the usual progress of the disease:  subsequent to vaccination, it is a mild and tractable disorder.  It is right, however, to mention that small-pox has occurred even to the vaccinated in almost as severe a form as the confluent natural small-pox, and running its regular course unaltered or unmodified.  Such instances, however, are extremely rare, and form the exceptions to the general rule; for “no reasonable doubt can be entertained, from the abundance of facts now before the world, that such modification is the law of the animal economy, and that the regular or natural progress is the exception.”

Maternal management.—­The grand principle in the treatment of small-pox is to moderate and keep under the fever; and however the plans adopted by different medical men may vary in particular points to accomplish this purpose, they uniformly make this principle their chief aim and object.  To carry out this intention, however, the medical adviser is greatly dependent upon the aid and assistance of a judicious parent, and without this it is impossible to hope for a successful issue to the case.  A clear knowledge, therefore, of those points of general management in which in fact a great part of the above principle consists (few and simple as these directions are), it must be all-important for the mother to be acquainted with:  for the rest, she must and ought to look to the medical man.

In the more rare and severe form of this disease, viz. the confluent small-pox, although in some instances it runs the same course as the milder form, the distinct or natural small-pox, still, usually, the constitutional symptoms are much more aggravated, and the medical and general treatment required will so much depend upon the character of the individual case, that we do not think it well to notice it here.

Bed and bed-room.—­It will not be necessary at first for the child to be confined to his bed, but generally about the third or fourth day he will gladly resort to it; and if he does not, it will be prudent to keep him there.  He must not, however, be loaded with bed-clothes, but lightly covered; and the bed and body linen should be changed daily, if possible.