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would be proper in an idiopathic inflammation of the same parts:

584. Whether the translation so frequently made from the extremities to the kidneys, is to be considered as an instance of the misplaeed gout, seems; as we have said before, uncertain ; but I am disposed to think it something different; and therefore am of opinion, that, in the Nephralgia Calculosa, produced upon this occasion, the remedies of inflammation are to be employed no farther than they may be otherwise sometimes necessary

in that disease, arising from other causes than the · gout.




585. THE diseases comprehended under this title, which make the third order of Pyrexiæ in our Nosology, are in general such as do not arise but upon occasion of a specific contagion applied, which first produces fever, and afterwards an eruption upon the surface of the body; and which diseases, for the most part, affect persons but once in the course of their lives.

586. Whether the character of the order inay be thus limited, or if the order may be allowed to comprehend also the eruptive fevers produced by a matter generated in the body itself, and likewise those cases of eruption which do not depend upon contagion, or upon a matter generated before the fever, but upon a matter generated in the course of the fever, I am not ready to determine. Of the diseases enumerated by the nosologists as Exanthemata, there are certainly three different kinds, which may be distinguished by the circumstances mentioned in this and the preceding paragraph. Of the first kind are the Small-pox, the Chicken-pox, the Measles, the Scarlet Fever, and the Plague. Of the second kind seems to be the Erysipelas; and of the third kind I judge the Miliaria and Petechia to be. But as I am not sufe ficiently confident in the facts which should supdort these distinctions, or which would enable us to apply them in all cases; I go on in this book to treat of almost all the Exanthemata enumerated by preceding nosologists, with only some differs ence in the arrangement from what it was in my former editions.



587. The Small-pox. it a disease arising from a contagion of a specific nature which first produces a fever, and, on the third or fourth day thereof, produces an eruption of small red pimples. These dre afterwards formed into pustules, containing a matter, which, in the course of eight days from the time of the eruption, is changed into pus. After this, the matter dries, and falls off in crusts.

588. This is a general idea of the disease ; but there are two particular forms or varieties of it; well known under the appellations of the Distinct and Confluent, which require to be specially de scribed.

589. In the former, or the distinct small-pox; the eruptive fever is moderate, and appears to be evidently of the inflammatory kind or what we name ä Synocha. It generally comes on about mid-day, with some symptoms of a cold stage, and commonly with a considerable languor and drowsiness. A hot stage is soon formed, and becomes more considerable on the second and third days. During this course, children are liable to frequent startings from their slumbers; and adults, if they are kept a-bed, are disposed to much sweating. On the third day, children are sometimes affected with one or two epileptic fits. Towards the end of the third day, the eruption commonly appears, and gradually increases during the fourth; appearing first upon the face, and successively on the inferior parts, so as to be completed over the whole body on the fifth day.

From the third day, the fever abates; and

against the fifth, it entirely ceases. The eruption appears first in small red spots, hardly eminent, but by degrees rising into pimples. These are generally upon the face in small number; but, even when more numerous, they are separate and distinct from one another. On the fifth or sixth day, a small vesicle, containing an almost colourless or whey-coloured fluid, appears upon the top of each pimple. For two days, these vesicles increase in breadth only, and there is a small hollow pit in the middle; so that it is only against the eighth day that they are raised into spheroidical pustules.

These vesicles or pustules, from their first form. ation, continue to be surrounded with an exactly circular inflamed margin, which, when the pustules are numerous, diffuses some inflammation over the neighbouring skin, so as to give somewhat of a damask rose colour to the spaces between the pustules. As the pustules increase in size, if they bę numerous on the face, against the eighth day the whole of the face becomes considerably swelled; and, in particular, the eye. lids are so much swelled as entirely to shut the eyes. '; . .

As the disease thus proceeds, the matter in the pustules becomes by degrees more opaque and white, and at length of a yellowish colour. On the eleventh day, the swelling of the face is abated, and the pustules seem quite full. On the top of each a darker spot appears; and at this place the

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