3o PRACTICE OF MEDICINE. 



at all events a dose of calomel and James' powder at night, fol- 

 lowed by a cathartic draught in the morning. 



When the functions of the different secerning and excerning 

 glands have been properly restored, tonics and alteratives should be 

 employed ; of the former class, the preparations of cinchona are 

 those most recommended. Cold applications have been recom- 

 mended by several writers ; this practice, however, is not always 

 safe, and should not be adopted when the persons are of broken- 

 down constitutions, or advanced in Hfe, or in erysipelas of the head. 

 Warm poppy fomentations are much safer. Mr. Higginbottom has 

 recommended the application of nitrate of silver^ in substance, or in 

 strong solution ; it should be applied either to the inflamed surface 

 and the adjoining integuments, or only to the healthy skin surround- 

 ing the affected part ; it should raise the cuticle, or it will fail in 

 isolating the disease. 



In the phlegmonous form,/rfe incisions should be employed early, 

 before the matter burrows deep, and causes much constitutional irri- 

 tation. Permanent and diffusible stimuli should be used, and if there 

 is much restlessness, opium should be exhibited, unless there is a 

 tendency to coma. Free incisions, followed by poultices, are the 

 most efficient means in this case, as they tend not only to allow of 

 the escape of matter which acts as a foreign body in the system, 

 but also to relieve the tension of the parts, and to destroy the inflam- 

 matory orgasm in them. Bleeding from the incisions should be 

 carefully watched, as it is sometimes profuse ; and it may, if uncon- 

 trolled, or unaccompanied by a sufficiently restorative treatment, 

 especially in drunkards and those of broken-down constitutions, be 

 attended by dangerous consequences. If the affection has been 

 neglected until sloughing has occurred, before incisions have been 

 made, lint dipped in oil of turpentine, or in equal parts of it and 

 Peruvian balsam, should be applied, and covered by warm poultices. 



VARICELLA {Chickeu Pox). 



Symptoms. — Varicella is a contagious fever, attended by vesicles 

 or pustules, which dry up from the fourth to the seventh day of their 

 formation, generally leaving small red spots, but rarely cicatrices on 

 the skin. In general, the invasion of varicella is preceded by slight 

 fever, which lasts from twelve to forty-eight hours. In some cases, 

 however, all the symptoms of violent gastro-intestinal irritation are 

 present — acute pain in the epigastrium, nausea, vomiting, &c. ; this 

 state will continue for three or four days. 



On the first day of the eruption, small, red, oblong, flat spots ap- 

 pear ; and on the second day, a prominent vesicle is observed at the 

 centre of them, containing a fluid of citron hue. The third day, the 

 colour of the fluid is yellowish. On the fourth day the vesicles 



