SURGERY. 
indolent swelling in tlie former, and a soft- 
ening, together with a carious affection, ot 
the latter. After remaining enlarged for a 
long time, the skin, covering a scrofulous 
tumour, becomes of a light purple^ ana 
bursts, discharging an unhealthy matter, 
and leaving an ill-conditioned sore. Such 
attacks take place in seve,ral parts. They 
generally occur in peculiar constitutions, 
and the affection is considered hereditary. 
In the treatment we endeavour to give 
strength to the constitution ; bark, sea-air, 
and sea-bathing are particularly service- 
able. Attention to the digestive organs is 
pa'rticularly necessary. Alkalies have ge- 
nerally been jrelied on, but without due 
grounds ; acids deserve a preference. The 
local treatment is not of much importance. 
The suppurations should not be opened. 
The scrofulous affections of the bones will 
be considered under Joints. 
Cow-pox (variolas vaccinm, vaccina, &c.). 
This is an universal poison, derived from 
certain specific sores^ on the teats and ud- 
ders of cows, and capable of being commu- 
nicated by accidental contact, where the 
cuticle has been removed, or by means of 
inoculation, to the human subject. A. per- 
son who has been thus affected, is rendered 
for ever after incapable of receiving the 
small-pox infection. That subjects, who 
had taken the vaccine disease accidentally, 
were tliereby secured from the small-pox, 
was popularly known in several of the dairy 
counties of England. But it was reserved 
for Jenner to show that the cow-pox could 
be propagated by inoculation, and that tlie 
inoculated disease possessed the same pro- 
phylactic power as the original disorder. 
Jt is not a merely local affection, but pro- 
duces a general, though extremely niild 
disturbance of the constitution, which is 
ordinarily so trivial as not to excite any 
alarm in the very youngest subjects. It 
seems probable, at present, that it is not an 
infallible security against the small pox, 
although the number of failures is very 
small, when due allowance has been made 
for the mistakes of tlie ignorant, and the 
misrepresentations of the designing, A 
small inflamed spot, distinguishable about 
tlie third day, shows that the inoculation has 
succeeded. This increases in size, becomes 
hard, and rises above the level of the skin. 
A small quantity of fluid can be discerned in 
the centre on the sixth day, and the pustule 
increases until the tenth day. This fluid 
will communicate the disease by inocula- 
tion. On the eightlt day, when the pustule 
is fully formed, the constitutional effects 
begin to appear, and manifest themselves 
by"slight pain in the part and axilla, head- 
ach, shivering, loss of appetite, &c. These 
subside spontaneously in one or tw'o days. 
During the general indisposition the pustule 
becomes surrounded with a broad circular 
inflamed margin, called the areola. After- 
wards the fluid dries up, and a dark brown 
scab forms, which remains for about a fort- 
night. 
Venei-eal disease. This arises from the 
application of a peculiar morbid poison to 
the body, which affects various parts in sue- 
cession. It first attacks the genitals of 
either sex, where it appears in the form of 
a circular ulcer or ulcers, with a white 
dirty concave surface, and thickened edge 
and basis, called chancres. These charac- 
ters distinguish them from various other 
ulcerations and excoriations, to which the 
same parts are exposed. The matter ab- 
sorbed from these causes swellings of the 
lymphatic glands, named buboes. After a 
certain length of time, an ulcerated soi e 
throat appears, attended with a pecnliar 
copper-coloured eruption on the skin. The 
ulcer of the throat is excavated, and the 
chasm appears foul on the surface, with an 
appearance like a white slough, and a de- 
fined edge. The eiaiptions vary consider- 
ably ; they have generally a reddish colour ; 
the cuticle peels off and forms again suc- 
cessively ; at last a true scab appears, un- 
der which ulceration takes place. Atter 
some time swellings of the bones, called 
nodes, appear, and gradually suppurate. 
These are very painful, particularly at night. 
The affections of the throat, skin, and bones, 
form what are called the constitutional symp- 
toms of the disease, or lues venerea. 
The treatment of this disorder, in all its 
stages, consists in the exhibition of mer- 
cury, until it produces its peculiar effects on 
the constitution : these are universal irrita- 
bility, quick pulse, &c. together with in- 
creased secretion of saliva, soreness ot the 
gums and month, &c. This action excited 
by mercury destroys the action of the dis- 
ease in all its foiins, and may'be considered 
as a specific and certain cure of the disor- 
der. The remedy is most freipiently intro- 
duced by friction on the thighs ; half a 
drachm being first employed for halt an 
hour every night, and increased to tw'O or 
three drachms. The pil. hydrarg. is the most 
common preparation for internal use ; it 
may be taken at first in doses of five grains, 
moiBing and night. Hydrarg, calcin,gr.ji 
