Ninety percent or more of smallpox cases among unvaccinated persons are of the ordinary type. In this form of the disease, by the second day of the rash the macules become raised papules. By the third or fourth day the papules fill with an opalescent fluid to become vesicles. This fluid becomes opaque and turbid within 24–48 hours, giving them the appearance of pustules; however, the so-called pustules are filled with tissue debris, not pus.
By the sixth or seventh day, all the skin lesions have become pustules. Between seven and ten days the pustules mature and reach their maximum size. The pustules are sharply raised, typically round, tense, and firm to the touch. The pustules are deeply embedded in the dermis, giving them the feel of a small bead in the skin. Fluid slowly leaks from the pustules, and by the end of the second week the pustules deflate, and start to dry up, forming crusts (or scabs). By day 16–20 scabs have formed over all the lesions, which have started to flake off, leaving depigmented scars.
Ordinary smallpox generally produces a discrete rash, in which the pustules stand out on the skin separately. The distribution of the rash is densest on the face; denser on the extremities than on the trunk; and on the extremities, denser on the distal parts than on the proximal. The palms of the hands and soles of the feet are involved in the majority of cases. Sometimes, the blisters merge into sheets, forming a confluent rash, which begin to detach the outer layers of skin from the underlying flesh. Patients with confluent smallpox often remain ill even after scabs have formed over all the lesions. In one case series, the case-fatality rate in confluent smallpox was 62%.
Famous quotes containing the word ordinary:
“The hearts of small children are delicate organs. A cruel beginning in this world can twist them into curious shapes. The heart of a hurt child can shrink so that forever afterward it is hard and pitted as the seed of a peach. Or, again, the heart of such a child may fester and swell until it is misery to carry within the body, easily chafed and hurt by the most ordinary things.”
—Carson McCullers (19171967)
“Television ... helps blur the distinction between framed and unframed reality. Whereas going to the movies necessarily entails leaving ones ordinary surroundings, soap operas are in fact spatially inseparable from the rest of ones life. In homes where television is on most of the time, they are also temporally integrated into ones real life and, unlike the experience of going out in the evening to see a show, may not even interrupt its regular flow.”
—Eviatar Zerubavel, U.S. sociologist, educator. The Fine Line: Making Distinctions in Everyday Life, ch. 5, University of Chicago Press (1991)
“Young people love what is interesting and odd, no matter how true or false it is. More mature minds love what is interesting and odd about truth. Fully mature intellects, finally, love truth, even when it appears plain and simple, boring to the ordinary person; for they have noticed that truth tends to reveal its highest wisdom in the guise of simplicity.”
—Friedrich Nietzsche (18441900)