II^MORRHAGIES. 249 



DCCCLXXVII. Though the matter expectorated upon these 

 occasions has the appearance of pus, it is seldom that of a laud- 

 able kind ; and as the ulcers do not readily heal, but are at- 

 tended with a hectic fever, for the most part ending fatally, I 

 presume that the matter of the ulcers is imbued with a pecu- 

 liarly noxious acrimony, which prevents their healing, and pro- 

 duces a phthisis in all its circumstances, as mentioned above. 



DCCCLXXVIII. It is very probable, that the acrimony 

 which thus discovers itself in the ulcers existed before, and pro- 

 duced the tubercles themselves ; and it is to this acrimony that 

 we must trace up the cause of the phthisis following these tu- 

 bercles. This acrimony is probably, in different cases, of dif- 

 ferent kinds ; and it will not be easy to determine its varieties : 

 but to a certain length I shall attempt it. 



DCCCLXXIX. In one case, and that too a very frequent 

 one, of phthisis, it appears that the noxious acrimony is of the 

 same kind with that which prevails in the scrofula. This may 

 be concluded from observing, that a phthisis, at its usual pe- 

 riods, frequently attacks persons born of scrofulous parents, that 

 is, of parents who had been affected with scrofula in their 

 younger years ; that very often, when the phthisis appears, 

 there occur at the same time some lymphatic tumours in the 

 external parts ; and very often I have found the Tabes mesenteri- 

 ca, which is a scrofulous affection, joined with the Phthisis pul- 

 monalis. To all this I would add, that, even when no scrofu- 

 lous affection has either manifestly preceded or accompanied a 

 phthisis, this last, however, most commonly affects persons of a 

 habit resembling the scrofulous, that is, persons of a sanguine, 

 or of a sanguineo-melancholic temperament, who have very fine 

 skins, rosy complexions, large veins, soft flesh, and thick up- 

 per lip ; and further, that in such persons, the phthisis comes 

 on in the same manner that it does in persons having tubercles, 

 as shall be immediately explained. 



DCCCLXXX. Another species of acrimony, producing tu- 

 bercles of the lungs, and thereby phthisis, may be said to be the 

 exanthematic. It is well known, that the smallpox sometimes, 

 and more frequently the measles, lay the foundation of phthisis. 

 It is probable also, that other exanthemata have the same ef- 

 fect ; and from the phenomena of the disease, and the dissec- 



