"Richard Preston - The Demon In The Freezer" - читать интересную книгу автора (Preston Richard)

darkens until it can look charred, and it can slip off the body in sheets. Doctors in the old days used to
call it black pox. Hemorrhagic smallpox seems to occur in about three to twenty-five percent of the fatal
cases, depending on how hot or virulent the strain of smallpox is. For some reason black pox is more
common in teenagers.
The rims of Barbara Birke's eyelids became wet with blood, while the whites of her eyes turned
ruby red and swelled out in rings around the corneas. Dr. William Osler, in a study of black-pox cases at
the Montreal General Hospital that he saw in 1875, noted that "the corneas appear sunk in dark red pits,
giving to the patient a frightful appearance." The blood in the eyes of a smallpox patient deteriorates over
time, and if the patient lives long enough the whites of the eyes will turn solid black.
With flat hemorrhagic smallpox, the immune system goes into shock and cannot produce pus,
while the virus amplifies with incredible speed and appears to sweep through the major organs of the
body. Barbara Birke went into a condition known as disseminated intravascular coagulation (DIC), in
which the blood begins to clot inside small vessels that leak blood at the same time. As the girl went into
DIC, the membranes inside her mouth disintegrated. The nurses likely tried to get her to rinse the blood
out of her mouth with sips of water.
In hemorrhagic smallpox, there is usually heavy bleeding from the rectum and vagina. In his
study, Osler reported that "haemorrhage from the urinary passages occurred in a large proportion of the
cases, and was often profuse, the blood coagulating in the chamber pot." Yet there was rarely blood in
the vomit, and somewhat to his surprise Osler noticed that some victims of hemorrhagic smallpox kept
their appetites, and they continued to eat up to the last day of life. He autopsied a number of victims of
flat hemorrhagic smallpox and found that, in some cases, the linings of the stomach and the upper intestine
were speckled with blood blisters the size of beans, but the blisters did not rupture.
At the biocontainment unit at Wimbern, the victim's deterioration occurred behind the chain-link
fence, in a room out of sight. Dr. Paul Wehrle may have visited her (he thinks not), but there was nothing
he could have said to her that would have helped, and nothing any doctor could do for her. He had seen
hundreds of people dying of hemorrhagic smallpox, and he no longer felt there was any medical
distinction among types and subtypes of the bloody form, that it was all an attempt by doctors to impose
a scheme of order on something that was just a mess. By the time I spoke with him, the cases had
flowed together in his mind, and he felt there was an inexorable sameness in the patients as the bleeding
and shock came on. "It was perfectly horrifying," he said.
Barbara Birke remained alert and conscious nearly up to the end, which came four days after the
first signs of rash appeared on her body. For some reason, variola leaves its victims in a state of
wakefulness. They see and feel everything that's happening. In the final twenty-four hours, people with
hemorrhagic smallpox will develop a pattern of shallow, almost imperceptible breaths, followed by a
deep intake and exhalation, then more shallow breaths. This is known as Cheyne-Stokes breathing, and
it can indicate bleeding in the brain. She prayed, and the nuns stayed with her. The Benedictine priest,
Father Kunibert, who had offered communion to Peter Los, ended up at Wimbern himself with a mild
case of smallpox. He may have given Birke her last rites. As the end approaches, the smallpox victim
can remain conscious, in a 'kind of frozen awareness-"a peculiar state of apprehension and mental
alertness that were said to be unlike the manifestations of any other disease," in the words of the Big Red
Book. As the cytokine storm devolves into chaos, the breathing may end with a sigh. The exact cause
of death in fatal smallpox is unknown to science.

People who are coming down with smallpox often exhibit a worried look, known as the "anxious
face of smallpox." A five-year-old girl named Rialitsa Liapsis, who came from a Greek family living in
Meschede, got a worried look and broke with severe pustulation in the Wimbern isolation unit. She had
been in a room at St. Walberga diagonally across the hall from Peter Los, suffering from meningitis,
though she had never seen Los's face. Rialitsa spent eight weeks recovering from smallpox in the
Wimbern unit, sobbing every day for her parents, who were forbidden to see her. The little girl shared
her room with Magdalena Geise, a nursing student who had worked on the second floor and had never