ERUPTIVE FEVERS. 153 



opaque appearance, and becomes whitish or brownish, but never 

 acquires the yellow colour and thick consistence that appear in 

 the distinct smallpox. 



DXCII. The swelling of the face which attends the distinct 

 smallpox when they are numerous, and almost then only, al- 

 ways attends the confluent, comes on more early, and arises to a 

 greater degree ; but abates on the tenth day, and on the eleventh 

 still more. At this time the pustules or vesicles break, and 

 shrivelling pour out a liquor that is formed into brown or black 

 crusts, which do not fall off for many days after. Those of the 

 face, in falling off, leave the parts they cover subject to a des- 

 quamation, which pretty certainly produces pittings. 



On the other parts of the body, the pustules of the confluent 

 smallpox are more distinct than upon the face, but never ac- 

 quire the same maturity and consistence of pus as in the pro- 

 perly distinct kind. 



The salivation which only sometimes attends the distinct 

 smallpox, very constantly attends the confluent ; and both the 

 salivation and the affection of the fauces above mentioned, are, 

 especially in adults, in a higher degree. In infants a diarrhoea 

 comes frequently in place of the salivation. 



" It has been alleged, that the smallpox occupy the internal 

 as well as the external surface. Dissections, however, have 

 shewn that they go into the fauces, but no farther." 



In the confluent smallpox, there is often a considerable pu- 

 trescency of the fluids, as appears from petechise, from serous 

 vesicles under which the skin shows a disposition to gangrene, 

 and from bloody urine or other hsemorrhagy : all which symp- 

 toms frequently accompany this disease. 



In the confluent smallpox, the fever, which had only suffered 

 a remission from the time of eruption to that of maturation, is 

 often, at or immediately after this period, renewed with consider- 

 able violence. This is what has been called the Secondary Fe- 

 ver ; and is, in different cases, of various duration and event. 



DXCII I. We have thus endeavoured to describe the various 

 circumstances of the smallpox ; and from the difference of these 

 circumstances, the event of the disease may be determined. 

 The whole of the prognosis may be nearly comprised in the fol- 

 lowing propositions. 



