76 SMALL- POX IN SHKKP. 



giimciit being affected by roseola or papula^, the patient 

 gives unequivocal signs of the febrile action set up in 

 the system; refuses his food, and shews but little 

 disposition to notice his companions or surrounding 

 objects. 



Many of the continental pathologists state, that 

 symptoms of fever, which continue unabated for two or 

 three days, precede the eruption on the body : our ex- 

 perience does not confirm this assertion ; for w^e have 

 never seen any indications of ill-health, or of the 

 mucous membranes, either of the respiratory or digest- 

 ive systems, being functionally deranged prior to the 

 eruption ; and we are of opinion that the morbid action 

 commences at the same time both in the mucous 

 membranes and the common integument. 



The papular is succeeded by the vesicular stage of 

 the disease, which is recognized by the elevations 

 hitherto red, becoming white in colour (^see plate 2). 

 This change depends on three particular causes ; first, 

 the effusion of a limpid fluid by the capillaries of the 

 papillated structure of the dermis ; second, the partial 

 imbibition of this fluid by the cells of the epidermis ; 

 third, the increase of the exudation separating the epi- 

 dermis from the dermis. We have elsewhere spoken 

 of the blanched appearance of the cuticle, and the im- 

 perfect development of vesicles ; it is not, however, to 

 be understood, that we mean by this description, that a 

 portion only of the epidermoid covering of each nodule 

 is raised, but that the elevation itself is slight, its size 

 being co-extensive with that of the papula. A careful 

 examination of the vesicles shews the cuticle to be 

 thicker than natural, and the openings of the sebace- 

 ous, perspiratory, and wool follicles very conspicuous. 



