120 PHYSIC 



the truth of the above assertions would be abundantly 

 proved. Moreover, we are convinced that many of the 

 exanthematous diseases, as well as skin eruptions gener- 

 ally, with the many anomalous "rashes" observed by the 

 practitioner from time to time, are alike, primarily, diseases, 

 or the outcome of diseases, of the nervous system. This 

 may be said to hold good also of many of the diseases of 

 the muscles and the various structures and viscera of the 

 body, or, in fact, wherever nerve structures, motor, sen- 

 sory, or sympathetic, are distributed. The key which 

 thus opens to us a way into the intricacies and labyrinths 

 of the nervine circulation is also, we venture to think, the 

 key which shall open the door of the therapeutic situation 

 in dealing with the whole family of the exanthematous 

 diseases. 



Eruption in its primary and simple varieties seems only, 

 or principally, to occur by the natural sweat ducts or the 

 rupture of the nerve terminal coverings and the escape 

 of their contents, fluid and plastic, together with the sub- 

 sequent subaerial changes which these latter are liable to 

 undergo in the production of definite papules, vesicles, 

 pustules, and crusts, as well as cuticular complications of 

 a desquamatory and inflammatory character. Cases of 

 variola, of a purely nervine variety and non-pustular, ter- 

 minate well and without pitting, but purulent cases, or 

 when the non-nervous elements of the skin are implicated, 

 less satisfactorily, while cases of a haemorrhagic description 

 terminate almost universally fatally, all which may be 

 regarded as pointing to the well-known methods of pro- 

 gress of the prevalent varieties and their natural history 

 along nervine lines. 



A vaccine or variolous vesicle may, therefore, be re- 

 garded as a limited or defined accumulation of tainted or 

 specifically poisoned cerebro-spinal fluid, plus the more 

 plastic contents or elements of the containing membranes 

 respectively, of the medullary and axis cylinder substances, 

 of the nerve terminals involved, together with the non- 

 nervous texture of the parts outlying the vesicle, which, 

 being almost entirely epidermic, do not necessarily touch 

 the blood or lymph textures. 



In the process of vesiculation in the eruptive stage of 



