fn t ce. 



in ita symptom* a scarcely erer to become the subject 

 of medical treatment ; and is only worthy of our notice, 

 as being sometimes confounded with slight cases of 

 Small-pox, and thin given rise to the idea of a second 

 attack of Variola, or of its occurrence after Vaccinia. 

 Varicella may, however, be distinguished from Small- 

 pox by the period of its successive stages, which are al- 

 together much shorter, not exceeding, in the whole, 

 >r six days, and in the nature of the fluid contain- 

 ed in the vesicles, which is watery and nearly tramps- 

 purulent 



rent, never 



'IT 1 



SCT. XXI. Scarlatina. Scarlrl Fever. 



Considerable difference of opinion has arisen on the 

 object of this disease, whether all the forms of it be- 

 long to one affection, of which they are merely van*. 

 ties ; whether the fever be symptomatic of the inflam- 

 mation of the throat ; or whether it more properly be- 

 longs U> the Exanthemata, where the fever and the erup- 

 tion arc both essential parts of the disease. This latter 

 we believe to be the correct view of the subject ; and 

 we farther conceive, that all the various forms which 

 Scarlet fever assumes are simply varieties, like thoat 

 which we noticed in Small-pox, principally depending 

 nan iu degree of virulence. 



The di Maae consists of a fever, which usually inclines 

 to UM iiifls.simaat.nrT type. About the fourth day the 

 iacc becomes swelled' and large patches of a red efflo- 

 rescence appear, which gradually sysasut over oooav 

 portion of the surface. These, in two or three 



Vuistiss. 



days, terminate in an exfoliation of small branny scales ; 

 a degree of innam frequently supervenes on the de- 

 cline of the other symptoms. Tin* may be conaidered 

 s* the simple form of the complaint, when it exists in 

 a mild degree ; but, in its more violent state, all the 

 symptoms are aggravated. The fever, from th* com- 

 mencement, haa more of the typhoid type; the redness 

 is more considerable; and, at the same time, the de- 

 glutition and the respiration arc affected, and an inflam- 

 mation is observed in th* internal fauces. These parts, 

 when first affected, exhibit a deep red colour ; they 

 arc quickly covered with a brownish Air ; and vesicles 



a purulent aspect, and finally de- 



(>reat general de- 

 patient is carried off in 

 a few days, with all the symptom* of cam plete exhaus- 

 tion, and an apparent tendency in the constituents of 

 th* body to 



y to fa 



The disease, when most acute, comet to its 

 five or six day*, and requires an equal period to patat 

 through the remaining stages. When it tsimsnatis fa- 

 tally, the event usually occurs from the sixth to the 

 tenth day ; but it not unfrequently happens that the 

 patient survives long after this period, and is finally de- 

 strayed, as it appears, from the effects of mere weak- 

 ness. It might appear highly improbable, that so se- 

 vere an affection as that of the throat should be only, 

 s* H were, an incidental part of the disease ; yet this 

 seems to be the case : for, in the same ay ii is mil, we 

 have some person* in whom the throat is severely af- 

 and others where it is not so, although, aa 



MEDICINE. 3 



fact, that they all hare an exact relation to the nature 

 or degree of the fever ; anil hence we deduce the prac- 

 tical consequence, that whatever means tend to subdue 

 the fever, will mitigate all the subsequent symptoms. 

 There is no complaint in whii-h the cold aff.isio.i prove* 

 so valuable a reined* a* in Scarlatina. The tempera* 

 ture of the body seems to be more increased in this 

 complaint than in any other febrile affection ; and we 

 find, that this method of applying cold, not only effec- 

 tually reduces the heat, but materially diminishes the 

 virulence of the duease, so as, in a gre.l measure, to 

 ward off the danger which arises from its putrid ten- 

 dency. If, however, these remedies fail in their de- 

 sired effect, or if we have not had an opportunity of 

 seeing the patient in the early period of the disease, we 

 have unfortunately to struggle with a succession of 

 symptoms, which it is commonly beyond our power to 

 remove. Bark and wine were, at one time, regarded 

 as essential to the cure; but, we apprehend, rather 

 from theoretical opinions, than from any experience of 

 their good effects. Emetics have been strongly recom- 

 mended, as well as acids and acrid stimulants, together 

 with topical remedies, such as have been supposed 

 were adapted to subdue the tendency' to putrefaction, 

 or to counteract the effect of the putrid matter that was 

 discharged from the ulcers. Some benefit appears to 

 have been gained by the use of stimulating gargles ; 

 but, in general, we shall find the severe form of the 

 scarlatina, when it arrives at its later stages, to be one 

 of the most untractable and formidable of all complaints. 

 Stimulants and excitants may be given, as affording 

 the only prospect of relief; and all circumstances are 

 to be carefully obviated, that may. in any way, ex- 

 haoat the languid powers of the patient, or produce 

 skfTll of morbid excitement. As the disease is ex. 

 the same means of prevention are 



Practice. 



tremely contagious, the 

 to be resorted to as we 



with respect to the two varieties of SfnaU-ppx, 

 every epidemic h it- characteristic form, or prevailing 

 tendency, in which one variety is met with mar* fre- 

 quently than the other. 



TreitsstBi. We are quite unacquainted with the nature of the 

 connexion which the different parts of the complaint 

 bear t each other, but we have learned the important 



above in other 



and we have reason to think, that the 

 power of extinguish- 

 ing or decomposing the contagion of Scarlatina as of 

 ty phus. Some difference of opinion has arisen respect- 

 ing the question, whether Scarlatina can occur twice in 

 the same person ? We Micve that it cannot do so in 

 any considerable degree ; yat it would appear, that the 

 same individual is subject to repeated attack* of a slight 

 local affection of the throat, and even to a degree of te- 

 rovided he is much about the person of the sick, 

 or immediately exposed to the source* of infection. 



Srcr. XXII. Rubevla. Mratla. 



The only remaining affection of the proper exanthe- Mcssles. 

 mtnin kind is the Measles, a disease which is charac- 

 terised by a fever of the inflammatory type, together 

 with all the symptoms of a violent catarrh, and parti- 

 cularly by a copious discharge of watery humo-ir from 

 the eyes and nose. About the fourth day an eruption 

 of small red points makes its appearance all over the 

 surface of the body, which, after continuing three or 

 four days, disappears without proceeding to suppu- 

 ration, and is succeeded by the dc*quaiiiution ol' the 

 cuticle, in the form of small branny scales ; the I 

 and catarrhal affection disappear about the same period. 

 A very remarkable circumrtancr in the history of medi- 

 cine is, that Scarlatina and Rubeola were not pro|>crly 

 distinguished from each other until about the com- 

 mencement of the last century, a circumstance which 

 haa led some writers to suppose tl> en- 



tirely a disease of modern time*, and that it did not ex- 



