MEDICINE. 
143 
is by acting on the imagination that empirics 
I uspend the threatened attacks of gout. In 
his, as in numberless other instances, faith in, 
onstitutes the virtue of, remedies ; both 
herefore in chronic rheumatism and gout, 
re might place among the curative agents 
netallic tractors, whether authorized by Per- 
k ins, or formed of old nails, as in the mstruc- 
ive experiments of Dr. Haygarth. Even a 
>iece of sealing-wax, or stick, when supposed 
>y the patient to be the genuine tractors, 
[operated in a most astonishing manner. (Iiay- 
garth on Perkins's 'Praetors.) The influence 
of the imagina ion over tlie body, whether 
l in health or disease, has not been sufficiently 
I acted upon in tiie professional practice ot me- 
dicine. The irregular affections in gout must 
be combated by stimulants carefuil adapted 
to the excitability ; for the spasmodic affec- 
tions of the stomach aromatics and bitters, 
I as ginger and quassia. It the head is affected 
I camphor, musk, ether, opium ; these likewise 
fare remedies lor the gouty asthma. I he 
Portland powder, which is a composition ot 
bitters and aromatics, may prove for a time 
highly useful ; but the protracted use of me- 
• dieines of tli s class is objectionable, as even- 
tually detrimental to the stomach and general 
fibre. Regular and steady, and not capri- 
cious and merely temporary, abstinence from 
wine, spirits, and spices. I lie body to be 
preserved gently open. Pure air, moderate 
! exercise, encouragement of cheerful habits. 
Warm and cold sea-bathing. Bath waters. 
Very small doses of digitalis. Hop (humulus 
lupulus) ? 
Order III. — Exanthemata, Eruptions. 
The exanthemata are more nearly allied 
to genuine fever than those disorders of which 
i we have just been treating, as the local af- 
I fections are consequences rather than causes 
of the general irritation. They have been 
! called eruptive fevers. They are defined by 
i Cullen contagious diseases, affecting a person 
only once during the whole of life, Com- 
i inencing with fever, and succeeded by erup- 
tion on the skin. Hie contagious matter 
upon which these depend may indeed ope- 
rate upon certain parts more particularly, 
and thus the disease be entitled to rank 
among the sensitive, irritative, or symptoma- 
tic fevers. This, however, is by no means 
certain: the primary action of cont gion, 
whether of a specific or general nature, has 
hitherto escaped the penetration ot the pa- 
thologist. 
Genus I. Erysipelas, St. Anthony’s fire. 
Symptoms. This disease does not corres- 
pond with the whole of the above definition ; 
it is not contagious ; and it has frequently 
| been found to recur. 'Hie face is the more 
* ordinary seat of this affection. After febrile 
irritation has commenced, and continued for 
a short time, during which there is often an 
unusual drowsiness, and sometimes delirium, 
the face suddmty becomes bloated, the eye- 
lids swell, and the skin is red and blistered. 
If the disorder is violent, or ili-treated, the 
inflammation and redness extend down the 
neck, and spread som dimes on toe shoul- 
ders : the tumid appearance of the couiite- 
nanc increases, delirium supervenes, and the 
patient has Deen known to die apoplectic. 
The erysipelas is an ey thematic inflamma- 
tion. Its seat is the rete mucosum. Its ten- 
dency is to gangrene rather thap to suppura- 
tion. A fatal termination is said to be prin- 
cipally on the 7th, 9th } or 1 1th days. 
M. M. In no other affection is it of more 
urgent moment to decide on the treatment 
by the nature of the prevailing diathesis. It 
has been observed, that in large and populous 
cities St. Anthony’s fire almost always appears 
in the form of asthenia ; and in this case re- 
quires wine, bark, opium : while in the hardy 
constitution of the rustic it assumes a sthenic 
character, and demands the vigorous em- 
ployment of what nas been called the anti- 
phlogistic regimen. Venesection. Saline 
purgatives. Diluent drinks. Might not di- 
gitalis be employed with a pro ject of sin- 
gular advantage, as the disease has an evident 
affinity with certain species ot dropsy ? With 
respect to external application, it has been 
customary to use mealy substances, such as 
flour. Solutions of lead, zinc, or alum, are 
improper, “ as they stimulate the secerning 
vessels into too great action.” (Darwin.) Cold 
water. 
Genus II. Pestis, the plague, is an epide- 
mic typhoid fever. 
Genus 111. Variola, small-pox. 
Symptoms. After tke pyrexial symptoms 
have continued for three days eruptions ap- 
pear on the skin, which on the eighth day 
contain pus, and at length fall off in crusts. 
Species, fhe small-pox is divided into the 
distinct, and confluent : the first has more of 
bed, walls, and floor, of the apartment. Pe- 
diluvium. 
N. B. For an account of the vaccine dis- 
ease, or cow-pox, see the article Vaccina- 
tion. 
Genus IV. Varicella. The chicken-pox is 
a very slight disease ; the eruptions some- 
times assume nearly the character of the 
distinct small-pox' ; but there is not much ir- 
ritation of the system, and they generally 
disappear in the course of three or four days 
from their first breaking out. 
Genus V. Rubeola. Measles. 
Symptoms. Pyrexia, sneezing, inflamed' 
eyes, dry cough, drowsiness ; about the 
fourth day, or later, small red points appear 
on the skin, which in the course of about 
three days fail off in branny scales. 
“ As the contagious material of the small- 
pox may be supposed to be diffused in the 
air like a fine dry powder, and mixing with 
the saliva in the mouth to infect the tonsils- 
in its passage to the stomach, so the conta- 
gious material of the measles may bn sup- 
posed to be more completely dissolved in the 
air, and thus to impart its poison to the mem- 
brane of the nostrils which covers the sense 
of smell; whence a catarrh with sneezing 
ushers in the fever.” Zoonomia. 
M. M. Measles too often lay the founda- 
tion of pulmonary consumption, to prevent 
which the symptoms denoting inflammation 
of the lungs are to be with much solicitude 
obviated ; and for this purpose small doses of 
are to be preferred to- 
Venesection cannot 
the sthenic, the latter of the asthenic, cha- _ 
racter. in the former the eruptions are of a i tincture of digitalis 
phlegmonic, in the latter of an erythematic | every other medicine 
or spreading, nature. Hie eiuption ot the! with propriety be used in young subjects, 
distinct small-pox makes its appearance in however imperiously called for ; and digita- 
circumscnbed red spots on toe face ; in the ! p s supplies its place without the risk of in- 
course of two days the _body and legs receive ducing indirect debility. Steady and cool 
theii portion. 1 he fevei now' ceases, the j atmosphere, not cold air in currents. Refri- 
fece swells, the pustules enlarge, and on the : gerant cathartics, with calomel. Animal food 
eighth day are mature. I he swelling ot the uo t to be given. Digitalis, with a very small 
face now goes on, and the hands and feet | quantity ot opium, for the cough succeeding 
begin to swell, with a slight return of fever, 
which however soon declines. 
in the confluent, or asthenic, species, .the 
fits are not so regular ; the eruptions are not 
circumscribed and prominent, but diffused, 
and scarcely appearing above the skin; a 
kind of eiysipelas sometimes pie^edes them, j anxiety and difficulty of breathing 
and eveiy symptom denotes debility. 1 lie the eruption. This disorder appear 
fatal termination is olten on the 11th day. 
Inoculation. 'Hie advantages of inocula- 
tion for the small-pox need not be insisted 
on. The circumstance, however, upon 
to measles. 
Genus Vf. Miliaria , miliary fever, is merely 
a symptomatic eruption of small red pim- 
ples about the neck and face, which in two 
days become white pustules, and desqua- 
I mate. r I hey have a peculiar smell. Much. 
I -.nvioi., -r i -‘i-i— precede 
uption. This disorder appears to be a 
consequence of an improper heating regimen, 
in fever. 
Genus \ II. Scarlatina, scarlet fever. 
Symptoms, & c. After pyrexia lias lasted. 
which depends the more favourable character about four days a scarlet eruption appears on 
ot inoculated over natural small-pox, does 
not appear to have been satisfactorily ac- 
counted for. The only cautions requisite in 
preparing for inoculation, are to preserve the 
bowels free from sordes, and to cfioo.se a time 
for the insertion ot the matter when teething, 
or other irritative processes, are not going on 
in the system. With respect to the time, it 
has been well said, that inoculation ought to 
he performed either before the second month, 
or after the second year. 
M. M. Cold air. The bowels to be pre- 
served open. Animal food to be denied. If 
tue fever runs high, antimonials and nitre. In 
the confluent species, the alimentary and in- 
testinal canal is with the utmost -oucitude to 
be preserved free from congestions by pur- 
gatives, and the powers of tire system sup- 
ported by opium, bark, small doses of nitre, 
w me, pure air; vinegar aspersed about the 
the kin, sometimes attended with inflamed 
tonsils and cervical glands: these last some- 
times appear without cutaneous eruption,, 
and the disease has been called cvnaiiche ma- 
ligna. This disorder is apt to be mistaken- 
tor measles ; but in scarlet fever there are no- 
catarrhal symptoms as in measles. T his dis- 
order is very irregular in its aspect; aiid. 
often, without much care, fatal in its termi- 
nation. Sometimes, without any alarming 
symptoms in the onset of the fever, a change- 
takes place, and in the course of a few hours: 
the patient falls into the arms of death. The- 
unfavourable symptoms arc the same as in. 
oilier fevers, ft is a disease principally of 
children. Whether it depend upon specific 
contagion, like measles and.sinuli-pox, is not' 
perhaps indy ascertained. 
M- I- Cold affusion. Cold air. Antimonials, 
opium, bark, wine, suune purgatives or enemas*, 
