$0% DISEASES CLASS II. 1. 3. 9, 



liam into distinct and confluent. The former consists of distinct 

 pustules, which appear on the fourth day of the fever, are cir- 

 cumscribed and turgid; the fever ceasing when the eruption is 

 complete. Head-ach, pain in the loins, vomiting frequently,, 

 and convulsive fits sometimes precede the eruption. 



The distinct small-pox is attended with sensitive fever only ? 

 when very mild, as in most inoculated patients; or with sensi- 

 tive irritated fever, when the disease is greater: the danger in 

 this kind of small-pox is owing either to the tumour and soreness 

 of the throat about the height, or eighth day of the eruption; 

 or to the violence of the secondary fever. For, first, as the natu- 

 ral disease is generally taken by particles of the dust of the con- 

 tagious matter dried and floating in the air, these are liable to be 

 arrested by the mucus about the throat and tonsils in their passage 

 to the lungs, or to the stomach, when they are previously mixed 

 with saliva in the mouth. Hence the throat inflames like the 

 arm in inoculated patients; and this increasing, as the disease 

 advances, destroys the patient about the height. 



Secondly, all those upon the face and head come out about 

 the same time, namely, about one day before those on the hands, 

 and two before those in the trunk; and thence, when the head 

 is very full, a danger arises from the secondary fever, which is a 

 purulent not a variolous fever; for as the matter from all these 

 of the face and head is reabsorbed at the same time, the patient 

 is destroyed by the violence of this purulent fever; which in the 

 distinct small-pox can only be abated by venesection and cathar- 

 tics; but in the confluent small-pox requires cordials and opiates, 

 as it is attended with arterial debility. See Sect. XXXV. 1. and 

 XXXIII. 2. 10. 



When the pustules on the face recede, the face swells; and 

 when those of the hands recede, the hands swell; and the same 

 of the feet in succession. These swellings seem to be owing to 

 the absorption of variolous matter, which, by its stimulus, excites- 

 the cutaneous vessels to secrete more lymph, or serum, or mucus, 

 exactly as happens by the stimulus of a blister. Now, as a blister 

 sometimes produces strangury many hours after it has risen, it 

 is plain, that a part of the cantharides is absorbed, and carried to 

 the neck of the bladder; whether it enters the circulation, or is 

 carried thither by retrograde movements of the urinary branch 

 of lymphatics; and by parity of reasoning the variolous matter 

 is absorbed, and swells the face and hands by its stimulus. 



Variola confluens. The confluent small-pox consists of nume- 

 rous pustules, which appear on the third clay of the fever, flow 

 together, are irregularly circumscribed, flaccid, and little ele- 

 vated, the fever continuing after the eruption is complete; con- 



