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above; and I have sometimes had occasion to observe, that even the admission of cool air was safe and useful.
729. This is, in general, the treatment of miŽiary eruptions : but at the same time, the remedies suited to the primary disease are to be employed; and therefore, when the eruption happens to accompany inflammatory affections, and when the fulness and hardness of the pulse or other symptoms shew an inflammatory state present, the case is to be treated by blood-letting, purging, and other antiphlogistic remedies.
Upon the other hand, when the miliary eruption attends diseases in which debility and putrescency prevail, it will be proper to avoid all evacuations, and employ tonic and antiseptic remedies, particularly the Peruvian bark, cold drink, and cold air.
I shall conclude this subject with mentioning, that the venerable octogenarian practitioner, De Fischer, when treating of this subject, in laying down the indications of the cure, has given this as one of them : • Excretionis periphericæ non primariam habere rationem.
OF THE REMAINING. EXANTIIEMATA ;-URTICARIA,
PEMPHIGUS, AND APHTHA.
730. The Nettle Rash is a name applied to two different diseases. The one is the chronic eruption described by Dr. Heberden in the Medical Transactions, vol. i, art. 17, which, as not being , a febrile disorder, does not belong to this place. The other is the Urticaria of our Synopsis, which, as taken into every system of nosology as one of the Exanthemata Febrilia, is properly to be treated of here.
731. I have never observed this disease as contagious and epidemic: and the few sporadic cases of it which have occurred to me, have seldom taken the regular course described by authors. At the same time, as the accounts of different authors are not very uniform, and hardly consistent, I cannot enter further into the consideration of this subject; and I hope it is not very necessary, as on all hands it is agreed to be a mild disease, and such as seldom require the use of remedies. It is generally sufficient to observe an antiphlogistic re. gimen, and to keep the patient in a temperature that is neither hot nor cold.
: 732. The Pemphigus or Vesicular fever, is a rare and uncommon disease, and very few instances of it are recorded in the writings of physicians. As I have never had occasion to see it, it would be improper for me to treat of it; and I do not choose to repeat after others, while the disease has yet been little observed, and its character does not seem to be exactly ascertained. Vid. Acta Helvetica, vol. ii, p. 260, Synops. Nosolog. vol. ii, p. 149.
733. The Aphtha, or Thrush, is a disease bet. ter, known; and, as it commonly appears in infants, it is so well understood, as not to need our treating of it here. As an idiopathic disease, affecting adults, I have not seen it in this country : but it seems to be more frequent in Holland ; and therefore, for the study of it, I refer to Dr. Boer. haave, and his commentator Van Swieten, whose works are in every body's hands.
734. The Petechia has been, by all our Nosologists, enumerated amongst the exanthemata ; but as, according to the opinion of most physicians, it is very justly held to be always a symptomatic affection only, I cannot give it a place here.
OF HAEMORRHAGY IN GENERAL.
735. In establishing a class or order of diseases under the title of Hæmorrhagies, nosologists have employed the single circumstance of an effusion of red blood, as the character of such a class or order. By this means they have associated diseases which in their nature are very different ; but, in every methodical distribution, such arbitrary and unna. tural associations should be avoided as much as possible. Further, by that management nosplogists have suppressed or lost sight of an established and well-founded distinction of "hæmorrhagies into active and passive.
736. It is my design to restore this distinction; and I shall therefore here, under the title of Hæmorrhagies, comprehend those only which have been commonly called Active, that is, those attended with some degree of pyrexia ; which seem
always to depend upon an increased impetus of the blood in the vessels pouring it out, and which chiefly arise from an internal cause. In this I follow Dr. Hoffman, who joins the active hæmorrhagies with the febrile diseases ; and have accordingly established these hæmorrhagies as an order in the class of Pyrexiæ. From this order I exclude all those effusions of red blood that are owing entirely to external violence ; and all those which, though arising from internal causes, are, however, not attended with pyrexia, and which seem to be owing to a putrid fluidity of the blood, and to the weakness or to the erosion of the vesa: sels, rather than to any increased impetus of the blood in them."
737. Before proceeding to treat of those proper hæmorrhagies which form an order in our Noso. logy: I shall treat of active hæmorrhagy in general; and indeed the several genera and species to be treated of particularly afterwards, have so many circumstances in coinmon with one another, that the general considerations to be now offered, will prove both proper and useful.
SECT. I. Of the phenomena of Hæmorrhagy. 738. The phenomena of hæmorrhagy are generally the following: