BOOK III. OF THE IMPETIGINES; OR, DEPRAVED HABIT, WITH AFFECTIONS OF THE SKIN. 1737. I FIND it difficult to give any sufficiently correct and proper character of this order. The diseases comprehended under it, depend, for the most part, upon a depraved state of the whole of the fluids, producing tumours, eruptions, or other preternatural affections of the skin. Although it be extremely difficult to find a general character of the order that will apply to each of the genera and species, I shall here treat of the principal genera which have been commonly comprehended under this order, and which I have enumerated in my Nosology. CHAP. I. OF SCROFULA, OR THE KING'S EVIL. 1788. THE character of this disease I have attempted in my Nosology; but it will be more properly taken from the whole of its history, now to be delivered. 1739. It is commonly, and very generally, a hereditary disease; and although it sometimes may, yet it rarely appears, but in children whose parents had at some period of their lives been affected with it. Whether it may not fail to appear in the children of scrofulous parents, and discover itself afterwards in their offspring in the succeeding generations, I cannot certainly determine; but believe that this has frequently happened. It appears to me to be derived more commonly from fathers than from mothers; but whether this happens from there being more scrofulous men than scrofulous women married, I am not certain. With respect to the influence of parents in producing this disease, it deserves to be remarked, that in a family of many children, when one of the parents has been affected with scrofula, and the other not; as it is usual for some of the children to be in constitution pretty exactly like the one parent, and others of them like the other; it commonly happens, that those children who most resemble the scrofulous parent become affected with scrofula, while those resembling the other parent entirely escape. 1740. The scrofula generally appears at a particular period of life. It seldom appears in the first, or even in the second year of a child's life; and most commonly it occurs from the second, or, as some allege, and perhaps more properly, from the third to the seventh year. Frequently, however, it discovers itself at a later period; and there are instances of its first appearance, at every period till the age of puberty; after which, however, the first appearance of it is very rare. 1741. When it does not occur very early, we can generally distinguish the habit of body peculiarly disposed to it. It most commonly affects children of soft and flaccid habits, of fair hair and blue eyes; or at least affects these much more frequently than those of an opposite complexion. It affects especially children of smooth skins and rosy cheeks; and such children have frequently a tumid upper lip, with a chop in the middle of it; and this tumour is often considerable, and extended to the columna nasi and lower part of the nostrils. The disease is sometimes joined with, or follows rickets; and although it frequently appears in children who have not had rickets in any great degree, yet it often attacks those who, by a protuberant forehead, by tumid joints, and a tumid abdomen, shew that they had some rachitic disposition. In parents who, without having had the disease themselves, seem to produce scrofulous children, we can commonly perceive much of the same habit and constitution that has been just now described. Some authors have supposed, that the smallpox has a tendency to produce this disease; and Mr. de Haen asserts its following the inoculated, more frequently than the natural, small-pox. This last position, however, we can confidently affirm to be a mistake; although it must be allowed, that in fact the scrofula does often come on immediately after the small pox. It is, however, difficult to find any connection between the two diseases. According to my observation, the accident only happens in children who have pretty manifestly the scrofulous disposition; and I have had several instances of the natural small-pox coming upon children affected at the same time with scrofula, not only without this disease being anywise aggra vated by the small-pox, but even of its being for some time after much relieved.. 1742. The scrofula generally shews itself first at a particular season of the year; and at some VOL. 11. E e time between the winter and summer solstice; but commonly long before the latter period. It is to be observed further, that the course of the disease is usually connected with the course of the seasons. Whilst the tumours and ulcerations peculiar to this disease, appear first in the spring, the ulcers are frequently healed up in the course of the succeeding summer, and do not break out again till the ensuing spring, to follow again with the season the same course as before. 1743. Frequently the first appearance of the disease is the tumid and chopped lip above mentioned. Upon other occasions, the first appearance is that of small spherical or oval tumours, moveable under the skin. They are soft, but with some elasticity. They are without pain; and without any change in the colour of the skin. In this state they often continue for a long time; even for a year or two, and sometimes longer. Most commonly they first appear upon the sides of the neck below the ears; but sometimes also under the chin. In either case, they are supposed to affect in these places the conglobate or lymphatic glands only; and not at all the salivary glands, till the disease is very greatly advanced. The disease. frequently affects, and even at first appears in, other parts of the body. In particular, it affects the joins of the elbows and ankles, or those of the fingers and toes. The appearances about the |