Darin Erantheasezia. Ezurrms Parses.
These consist of the following genera : 1. Erysipelas, or St. Anthony's fire. 2.Pes tis ; plague. 3. Variola ; small-pox. 4. Va ricella ; chicken-pox. 5. Rubeola ; mea sles. 6. ICliary ; miliary fever. 7. Scar latina ; scarlet fever. S. Urticaria ; nettle rash. 9. Pemphigus ; bladdery fever. 10. Aphthae; thrush. The whole of this order is defined by Cullen to consist of diseases affecting persons only once in their life, commencing with fever, and succeeded by phlogoaes, generally small in size, con siderable in number, and dispersed over the skin. The definition, however, will not bold good in several of its clauses, And especially in its first ; for, perhaps, there is not a single disease in the hat, but what has occasionally recurred, and many of them repeatedly. It is to be remarked, through the whole of these, that, whatever danger may accompany them depends rather upon the degree of fever, and the nature of the fever that in troduces them, than upon the extent or nature ofthe eruptions themselves : and hence, with very few exceptions, the general plan laid down for the treatment of the different genera, in the order Febri, is the plan which ought to be fol lowed in the order before us. Thus the fever accompanying plague is evidently typhus, which, in effect, when accom panied by eruptions of any kind, is evi dently a typhoid eruptive fever, and re quires the same treatment as typhus. Chicken-pox, and nettle-rash, have a near approach to synocha, and so far possess the same indications; but they are gene rally slight diseases, and of not more than three days' duration. The rest, for the most part, are of a mixed breed, and have hence a closer resemblance to synochus: they commence with inflammatory affec tions; but have soon a strong tendency to run into the putrid type. We shall select an example or two from the dis eases of this order, either most important or most frequent.
Variola. Small-pox. This is of two varieties, the distinct and the confluent. The general nature, symptoms and treat ment of the former, are so well known, that it is unnecessary to repeat them. In the confluent kind, our chief attention must be directed to support the of the system, and to obviate the tendency to great depression of strength and putre faction of the fluids, which will be effect ed by the exhibition of cordials, wine, bark, mineral acids, and a nourishing diet, and by all the means recommended in the treatment of typhus, except the ap plication of cold water after the appear ance of the eruption ; the bowels should be kept regular by the mildest cathartics, or by laxative clysters ; some authors, however, recommend a more liberal use of them, unless a diarrhma has superven ed, even when the disease assumes the type of typhus. When the disease is at
tended with violent symptoms, blisters should be applied in succession, on dif ferent parts of the body, without regard to the parts being covered with pustules; if there be obstinate vomiting, the saline draughts should be given in a state of effervescence ; or camphor, combined with opium, may be employed with ad vantage ; the extract of cascarilla, ad ministered in some aromatic liquid, is often of use in allaying the vomiting; and if we do not succeed by those means, it will be proper to apply a blister to the region of the stomach : should the epilep tic fits continue violent, it will be neces sary to administer opiates, both by the mouth and by clysters, which act, not only by their antispasmodic power, but also by perspiration, and mustard cats plasms should be applied to the feet ; at the same time gentle cathartics will be necessary, as the recurrence of the fits frequently proceeds from the irritation of retained faces, especially in children : when a retrocession of the eruption hap pens, wine, opium, volatile alkali, musk, and camphor, with the warm bath, are the remedies most generally employed; blisters and mustard cataplasms should also be applied to the lower extremities : if the swelling of the face subsides sud denly, and is not succeeded by the swell ing of the hands, blisters are recom mended to be applied to the wrists and fore-arms; anointing great part of the body with mercurial ointment, or apply ing a large mercurial plaster to the scro biculus cordis, under the same circum stances, is often attended with good effects ; if the salivation suddenly cease, without any swelling of the hands, blis ters should be applied to the wrists, and small doses of ipecacuanha should be ad ministered : should there be a suppres sion of urine, the patient should be ex posed to a current of cool air ; if this does not succeed, and he is not in a very de bilitated state, and the heat of the body is steadily above the natural degree, it will be proper to dash cold water upon the legs ; and perhaps to extend the af fusion over the whole surface.