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This well-written and complete monograph contains many startling facts about this ancient malady. With the unfamiliarity which now exists concerning this disease in the United States, one would be very hard pressed to diagnose fulminating smallpox when there is no rash, or even a more typical vaccino-modified case with abortive lesions. Dr. Dixon's chapters on classification of cases, with numerous excellent pictures do a great deal to clear up the confusion concerning the clinical variations of smallpox.
Many persons today, including physicians, ignore the threat of smallpox. Large percentages of our population are unvaccinated or have not been re-vaccinated in the recent past. In the Rochdale outbreak in 1951-1952, there were 116 cases, and all but 15 of these were unvaccinated. Prior to the outbreak in Pennines in 1953, only 20% of infants had been vaccinated in that area. Dr. Dixon's illustrations of severe cases of smallpox with old vaccination
Sprague EA. Smallpox. Arch Dermatol. 1964;89(2):310–311. doi:10.1001/archderm.1964.01590260148032
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