THE FOLLOWING CASES are not given with the conviction that the disfigurement resulting from small-pox may be invariably prevented but rather for the purpose of calling attention to, and inviting further trial of, the treatment that I used.

The terrible seaming and pitting of the face, neck and other exposed parts of the body so often consequent on bad attacks of small-pox are universally known. Reference, however, is seldom made to the total exemption of the scalp from marking of any kind, after even the severest form of this disease.

The scalp is protected from pitting by hair

During the last few years I have habitually sought out and examined men and women badly marked from small-pox, for the purpose of ascertaining how often, and to what extent, the scalp was also marked. Many cases have passed under my notice in prisoners admitted to the Government prisons. The scalp in every case was without a trace of marking. I have repeatedly seen both men and women seamed and pitted as badly as possible, but I have invariably found that all marking ceased at the border of the hair. The covering afforded by the hair had evidently preserved the scalp from injury and from subsequent pitting.

It recently occurred to me, from watching a photographer using cotton-wool to shut out light in the process of ‘vignetting’ photographs, that this material, if applied to the face and neck of small-pox patients, might give a protecting influence somewhat similar to that afforded to the scalp by the hair, and thereby prevent or modify the subsequent pitting.

Protection by cotton-wool

I have two cases convalescent from small-pox in which I applied cotton-wool to protect the face. The disease in each case was of the distinct form. One of the two, a girl, aged fifteen years, had an abundant eruption, which, in the unprotected parts of the body, went through the usual consecutive changes. In both cases, these parts covered with the wool are left without a vestige of marks.

The mode of application was as follows: On the first appearance of the eruption, patches of skin about an inch square were washed over with collodion, and immediately covered with a thin uniform layer  of fine wool: the wool readily adheres if applied before the ether of the collodion evaporates.

When the whole of the face, etc, was thus covered, the wool was brushed over with a solution of starch or gum. The starch or gum was occasionally reapplied to the edges of the wool to prevent any shifting by the movements of the face.

 This covering was kept on until the dry crusts fell off the other parts of the body.

As stated earlier in both cases, the faces covered with the wool are left without a vestige of marks.