SIBBENS. 



moderate, and have fubfided, the fecondary fymptoms, 

 aff'efting the fliin fuperficially, afl'ume different fhapes. 

 The whole furface of the body, Dr. Gilchrill fays, has 

 been obferved to be mottled, of a duiky copper colour, or 

 a dirty hue, as the difcolourings of the fldn in this difeafe 

 commonly are. Infants of the month have had a rednefs in 

 the lower part of the belly, buttocks, thighs, and part of 

 the legs, where fometimes it terminates abruptly in a ring. 

 In fome of thefe there was an inflammation, and a watery 

 fhining fwelling of the pudenda. A more certain appear- 

 ance in fuch fubjeds fomewhat older are broad red patches, 

 as large as the palm of the hand, over all the trunk, as well 

 as the limbs, attended with inflammation. A duller, or 

 cluiters, of fmall puftules come out ; the ll<in grows dry, 

 and peels off, leaving a new tender fkin beneath ; and this 

 will happen a great many times, fometimes in one place, 

 fometimes in another. Scabby eruptions are often met with 

 on the fcalp, fore-head, infide of the thighs, groins, and 

 parts contiguous ; where frequently fmall hardneffes, rifing 

 juft within the fkin, excite a very troublefome itching. Be- 

 fides the inflammation and excrcfcences about the fundament 

 already noticed, other appearances of the difeafe prefent 

 themfelves on the bread, fhoulder?, and elfewhere, efpe- 

 cially a fort of ier/ifs exedens, or fpreading tetter, healing 

 in one part, while it breaks out in another adjoining, and 

 leaving a great deformity of the fkin, after it cicatrizes. 

 In a few cafes, an eruption of tubercles occurs upon the 

 face, rather numerous, and in figure and fize refembling the 

 fmall-pox at the height, but being of a reddifh colour. 

 Thefe are attended with great heat and tumour of the face, 

 fo as fometimes to clofe up the eyes. In fome cafes they 

 have fpread thickly over the whole body, and fuppurated, 

 not unlike the confluent fmall-pox, and have even proved 

 fatal, as the fwelling fubfided ; but in others, where not 

 fo numerous, they gradually decay, without coming to 

 fuppuration. In fome perfons there is a fwelling of the 

 furface, without any appearance of tubercles ; in which 

 cafe, the cuticle exfoliates from time to time in fine white 

 reticulated flakes, as often as it is renewed. In other cafes, 

 tubercles arife from fmall bright red fpots, of a more in- 

 tenfe rednefs than thofe juft mentioned, which in fome 

 places become confluent, and form a flat fmooth elevation, 

 which foon becomes of the ufual colour of the fliin, and 

 fometimes flightly ulcerates. The face, too, is often af- 

 fefted with different kinds of eruption, fometimes alone, 

 and fometimes together with the reft of the body. 



Where the difeafe affumes ftill greater malignity, larger 

 boils appear difperfed over the arms, flioulders, face, legs, 

 and feet, which fuppurate, and form ulcers, which pene- 

 trate to the mufcular parts, laying them quite bare, and 

 feeming even to corrode them fuperficially. Thefe ulcera- 

 tions are of a high florid colour, with fcarcely any dif- 

 charge upon their furface, except a little ichor, which ren. 

 ders them exquifitely tender and painful, and fcarcely bear- 

 ing the mildelt apphcations. Their edges are hard and 

 ragged, their fize various, and their appearance very ma- 

 lignant J fo that Dr. Gilchrift fays, when viewed fingly, 

 they might have been miftaken for real cancers ; but the 

 number of them, the manner of their coming out, and other 

 circumflances, foon determine the difeafe to which they 

 belong. 



There is one fymptom, not yet particularly defcribed, 

 but from which the difeafe takes its name, which remains 

 to be mentioned. An itchy tetter, or a fort of ring-worm, 

 breaks out in a circular form, which either Ipontaneoufly, 

 or from being fcratched, becomes raw and excoriated, and 

 does not fcab, but continues to ooze out an ichorous hu- 



8 



mour. In a fhort time a fungous excrefcence fprouts up, 

 much like a rafpberry or ifrawberry, elevated one half 

 above the furface, and, when fully formed, appearing as 

 if fet in a focket cut in the flefh exaftly to receive it. 

 Sometimes, however, a black fcab forms, crulling over the 

 fore, except at thr edges, where there is a crack or ring, 

 like the line of feparation between a mortified and a found 

 part, from which the fame fort of ichor is conllantly oozing. 

 By degrees this crack enlarges towards the centre, and 

 the fcab, being pulhed off, gives place to the fungus 

 juit defcribed. In other cafes, thefe fpongy excrefcences 

 are preceded by a dark or grey fcurf, reiembling the fcaly 

 leprofy. Ttiefe parts are the leat of an intenfe itching, and 

 when they are excoriated by fcratching or rubbing, the 

 fungus has room to fprout up. Thefe fores occupy every 

 part of the body, and many of them are feen in the fame 

 lubjedt at the fame time ; but the excrefcences do not al- 

 ways fprout up, and are more commonly produced in the 

 fores which never form a fcab, than in the fcabby or fcaly 

 ones. The fungus is rather indolent than tender to the- 

 touch, and its colour is not remarkably different from thai 

 of the fungus of other fores. 



The fibbens very rarely affefts the bones, and then only 

 by extending from the foft parts, and perhaps never attacks 

 the large and more folid bones. In feveral cafes, the teeth, 

 with their fockets, have been lotl, and fome of the bones of 

 the cheeks and nofe have come away, and a portion of the 

 cartilaginous feparation of the noflrils has been deftroyed by 

 the difeafe. Several perfons die in a flate of heftic, from 

 the very extenfive ulcerations, before the bones could be 

 materially affefted. 



Caufes of Sibhens. — This difeafe has been principally pre- 

 valent among the lower ranks of the people in Scotland, 

 though not exclufively ; for fome families of good condition 

 have loll their children by its attacks. The difeafe affefts the 

 young and adult perfons equally ; but perfons advanced in 

 years appear to be lefs liable to the infeftion. Children, 

 however, and women, from their more irritable frame, are 

 moll fufccptible of it. 



The difeafe is commonly communicated by the dire6t 

 conveyance of the infeftious matter by fome fpecies of con- 

 taft, and generally through the medium of the mouth ; 

 whence the primary fymptoms appear in the mouth and 

 throat, as before defcribed. " It is propagated," Dr. 

 Gilchrifl obferves, " by ufing the fame fpoons and knives, 

 and wiping with the fame cloth, which the infefted have 

 ufed, without cleaiiCng or wafhing them ; drinking out of 

 the fame glafs or cup ; fmoakmg with the fame pipe ; 

 fleepmg with the infected, or in the fame bed-clothes they 

 have lain in, and handling their fores ; by fucking or giving 

 fuck ; fainting, or killing, and fondling children, or feeding 

 them in an uncleanly way." 



Dr. Gilchrill adds, that it is completely proved, that the 

 fibbens is propagated chiefly by thefe inattentions to clean- 

 linefs, by this circumllance, that " it has never got footing 

 among thofe of better fafhion," nor in towns, where, ex- 

 cept with the very lowefl, greater attention to cleanlinefs is 

 generally obferved ; and that it was unknown among the 

 more cleanly i.ihabitants of the Englifh border, while it 

 occ .rred at Dumfries, and along the Scottilh boundary. 

 Another proof wjs deduced from the more frequent occur- 

 rence of the difeafe after autumn, which was thus accounted 

 for. " A company of reapers is made up of very different 

 people, brought together from all parts : they eat and drink 

 promifcuoufly out of the fame cups and difhes ; and a few 

 fpoons are made to ferve a good many, by putting them 

 round from one to another. The fame is done with a 



pipe 



