August Newsletter - 2004

Books Corner:

Smallpox

C.W.Dixon, MD, DLO, DCH, DPH

J & A Churchill, Ltd.

London, 1962

Dixon's book stands as one of the greats of smallpox literature. For infectious disease scholars, public health bioterrorism planners and clinicians likely to be involved in the initial cases of a bioterrorist attack using smallpox, it is well worth the effort to obtain a copy of this long out of print classic.

For a clinician, the first four chapters are particularly instructive and very well illustrated, (the illustrations alone are worth the cost of the book).  In those initial chapters the author discusses in considerable detail the clinical characteristics and differential diagnoses of several types of smallpox, ranging from the rapidly fatal and difficult to diagnose Fulminating smallpox to what he classified as the abortive type with fewer than 20 lesions present.  At both extremes of the disease it will clearly be a matter of good fortune smallpox to be recognized before an epidemic takes hold.

I found Dixon's chapter on Complications, Treatment and Nursing Sequelae particularly enlightening. Most contemporary writings about smallpox are notable for their lack of discussion about the complications of this disease and omission of the tremendous nursing demands imposed by this virus. Equally instructive were the chapters detailing hospital considerations and the epidemiologic issues associated with the smallpox hospitals of the mid 20th century. That chapter would also be good reading for those responsible for hospital-based bioterrorism preparedness.

For those concerned with the public health aspects of smallpox preparedness, the chapters on the Principles of Smallpox Control and The Smallpox Hospital are not only very useful but should be required reading.

Finally, the students of the history of medicine will find the three chapters devoted to the history of smallpox particularly rich, with many sections reproduced from original sources. The book is very well documented with over 600 citations. I found it to be a venerable treasure trove of historical sources.

Have a question or comment? Email bioterr@slu.edu