38 PRACTICE OF PHYSIC. 



could not inspect the fauces ; but in that case we may know of 

 its presence by the flow from the nose."" 



CCCXIII. With these symptoms, the pyrexia proceeds with 

 a small, frequent, and irregular pulse ; and there occurs a ma- 

 nifest exacerbation every evening, and some remission in the 

 mornings. A great debility appears in the animal functions ; 

 and the sensorium is affected with delirium, frequently with coma. 



CCCXfV. On the second day, or sometimes later, efflores- 

 cences appear upon the skin, which are sometimes in small 

 points hardly eminent, but for the most part in patches of a 

 red colour, spreading and uniting so as to cover the whole skin. 

 They appear first about the face and neck, and in the course of 

 some days spread by degrees to the lower extremities. The 

 scarlet redness is often considerable on the hands and extremi- 

 ties of the fingers, which feel stiff and swelled. This eruption 

 is often irregular as to the time of its appearance, as to its stea- 

 diness, and as to the time of its duration. It usually continues 

 four days, and goes off by some desquamation of the cuticle ; 

 but neither on its first appearance, nor on its desquamation, 

 does it always produce a remission of the pyrexia, or of the other 

 symptoms. 



CCCXV, The progress of the disease depends on the state 

 of the fauces and of the pyrexia. When the ulcers on the 

 fauces, by their livid and black colour, by the fetor of the 

 breath, and by many marks of acrimony in the fluids, show a 

 tendency to gangrene, this takes place to a considerable degree ; 

 and, the symptoms of a putrid fever constantly increasing, the 

 patient dies, often on the third day, sometimes later, but for 

 the most part before the seventh. The acrimony poured out 

 from the diseased fauces must necessarily, in part, pass into the 

 pharynx, and there spread the infection into the oesophagus, 

 and sometimes through the whole of the alimentary canal, pro- 

 pagating the putrefaction, and often exhausting the patient by 

 a frequent diarrhoea. 



The acrid matter poured out in the fauces being again ab- 

 sorbed, frequently occasions large swellings of the lymphatic 

 glands about the neck, and sometimes to such a degree as to 

 occasion suffocation. 



