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No remedies, and the purgatives, which, as has been said before, are by some practitioners con. tinued, prove often hurtful.
But when, upon the eruption, the pimples on the face are very numerous; when they are not distinct; and especially when, upon the fifth day, the fever does not suffer a considerable remission; the disease will still require a great deal of attention,
622. If, after the eruption, the fever shall continue; the avoiding heat, and the continuing to expose the body to a cool air, will still be proper. If the fever be considerable, with a full and hard pulse, in an adult person, a bleeding will be necessary; and more certainly, a cooling purgative. It is, however, seldom that a repetition of the bleeding will be proper, as a loss of strength does usually come on very soon; but the repetition of a purgative, or the frequent use of laxative glysters, is commonly useful.
623. When a loss of strength, with other marks of a putrescent tendency of the fluids appears, it will be necessary to exhibit the Peruvian bark in substance, and in large quantity. In the same case, the free use of acids, and of nitre, is useful; and it is commonly proper also to give wine very freely.
624. From the fifth day of the disease, onward
through the whole course of it, it is proper to give an opiate once or twice a-day; taking care, at the same time, to obviate costiveness, by purgatives, or ļaxatiye glysters.
625. In a violent disease, from the eighth to the eleventh day, it is proper to lay on blisters successively on different parts of the body, and that without regard to the parts being covered with pustules.
· 626. If, in this disease, the tumour of the fauces be considerable; the deglutition difficult; the saliva and mucus viscid, and with difficulty thrown out; it will be proper to apply blisters to the external fauces, and to employ diligently detergent gargles.
627. During the whole course of the disease, when any considerable fever is present, the fre. quent exhibition of antimonial medicines, in nau. seating doses, has been found useful; and these, for the most part, sufficiently answer the purpose of purgatives. ..
628. The remedies mentioned from 622, to 626, are those frequently necessary, from the fifth day, till the suppuration is finished. But as, after that period, the fever is sometimes continued and increased; or, as sometimes, when, after there has been little or no fever before, a fever now arises, and continues with considerable danger ; this is what is called the secondary feyer, and requires particular treatment,'.!
629. When the secondary fever follows the distinct small-pox, and the pulse is full and hard, the case is to be treated as an inflammatory affection by bleeding and purging. , But, if the secondary feyer follow the confluent small-pox, and be a continuance or exacerbation of the fever which had subsisted before, it is to be considered as of the putrid kind; and in that case, bleeding is improper. Some purging may be necessary; but the remedies to be chiefly depended on, are the Peruvian bark and acids.
. When the secondary fever first appears, whether it is after a distinct or a confluent small-pox, it will be useful to exhibit an antimonial emetic in nauseating doses, but in such a manner as to produce some vomiting.
630. For avoiding the pits which frequently follow the small-pox, many different measures have been proposed; but none of them appear to be sufficiently certain,
OF THE CHICKEN-POX.
631. This disease seems to depend upon a spe. cific contagion, and to affect persons but once in their lives. It is hardly ever attended with any danger; but as it seems frequently to have given occasion to the supposition of a person's having the small-pox twice, it is proper to study this disease, and to distinguish it from the genuine small-pox.
632. This may be generally done by attending to the following circumstances.
The eruption of the chicken-pox comes on with very little fever preceding it, or with fever of no determined duration.
The pimples of the chicken-pox, more quickly than those of the small-pox, are formed into little vesicles or pustules.
The matter in these pustules remains fuid, and never acquires the colour or consistence of the pus which appears in the pustules of the small-pox.
The pustules of the chicken-pox are always, in three or four days from their first appearance, formed into crusts.
See Dr. Heberden in Med. Transact, Vol. I, Art. xvii.
633. This disease also depends upon a specific contagion, and affects persons but once in their lives.
634. It occurs most frequently in children; but no age is exempted from it, if the persons have not been subjected to it before.
635. It commonly appears as an epidemic, first in the month of January, and ceases soon after the summer solstice; but various accidents, introducing the contagion, may produce the disease at other times of the year.
635. The disease always begins with a cold stage, which is soon followed by a hot, with the ordinary symptoms of thirst, heat, anorexia, anxiety, sickness, and vomiting; and these are more or less considerable in different cases. Sometimes from the beginning the fever is sharp and violent; often, for the first two days, it is obscure and inconsiderable, but always becomes violent before the eruption, which usually happens upon the fourth day,