PATHOLOGY. 
of the cutaneous circulation from violent exercife in hot 
weather or in heated rooms, efpecially when followed by 
a copious draught of cold liquor. This difeafe occafion- 
ally puts on a much fevererafpeCh In the form to which 
the term in dura fa is more ftriCHy applied by Bateman, 
hardnefs is a remarkable feature in the appearance of the 
tubercle, which is at the fame time more permanent, and 
more apt to fpread from the face to the neck and (hould- 
ers, than in the preceding form. The tubercles are oc- 
cafionally acuminated, as if tending to immediate fup- 
puration, being at the fame time of a bright rofeate hue : 
yet many of them continue in a hard and elevated ftate 
for a great length of time, without any difpofition to 
fuppurate- Others, however, pafs on very (lowly tofup- 
puration, the matter not being completely formed in them 
for feveral weeks, and then only a final 1 part of the tu¬ 
bercles are removed by that procefs. Sometimes two or 
three coalefce, forming a large irregular tubercle, which 
occafionally fuppurates at the feparate apices, and fome- 
tiines only at the largeft. In whatever mode they pro¬ 
ceed, their vivid hue gradually becomes more purple, or 
even livid ; and their tendernefs is then extreme. 
Slight crufts form upon the fuppurating tubercles, which 
after fome time fall off, leaving fmall fears furrounded 
by hard tumours of the fame dark red colour ; and thefe 
fometimes fuppurate again at uncertain periods, and 
fometimes (lowly fubfide and difappear, leaving a purple 
or livid difcoloration, and occafionally a (light depreflion, 
which is long in wearing off. 
The general treatment of this diforder will be con¬ 
duced on the fame principles as (light inflammatory com¬ 
plaints in all parts of the body, when thefe a rife from 
internal irritation. The mod frequent caufe of this 
difeafe, as the fagacious Darwin remarked, is found in 
deranged aCtion of the chylopoi'etic vifeera. Dr. Bateman 
indeed does not feem to allow this ; for he fays that the 
patients of this complaint often enjoy good health, and 
that it is generally a local difeafe. But whoever confi- 
ders the caufes which, according to this author’s account, 
aggravate varus, will have little hefitation in concluding 
that the fame caufes may often produce the complaint. 
According to the teftimony of Dr. B. himfelf, the treat¬ 
ment of this complaint by repellent lotions often gives 
rife to vicarious difeafe in other parts; an occurrence 
which will never happen, we believe, if, previous to the 
life of thofe applications, we regulate by gentle purga¬ 
tive and abftinent diet the ftate of the ftomach and 
bowels. . The local applications to be ufed are weak fti- 
muli of various kinds ; as lotions of water with a fmall 
proportion of fpirits of wine, or a few grains of oxymu¬ 
riate of mercury, the ftrength of the latter being gra¬ 
dually increafed (to a great degree when the tubercles 
are indurated) as the difeafed part lofes its inflammatory 
character. 
£. Pun&atus, the maggot-pimple: tipped with a black 
dot, difeharging, on the preflu re of the finger, a grub¬ 
like concretion of mucus. In other refpe&s this is fimi- 
lar to the former variety. The indurated mucus may be 
extracted by the fingers, or by means of a fmall blunt 
curved forceps, and the little tumour treated as the firft 
variety. In Plate II. fig. i, we have given a re prefen ta- 
tion of Ionthus varus; and at A are depicted a few of 
the black punftas which give character to the fecond va¬ 
riety. 
2 , Ionthus corymbifer, (Acne rofacea, Bateman.) 
Rofy drop, or whelk : confluent ; corymbofe ; rofy mot¬ 
tled with purple ; often disfiguring the noftrils with pen¬ 
dulous lobes; irritated by cordials or expofure to heat. 
See Plate II. fig. a. 
This complaint occurs from a greater intenfity of the 
fame caufe that gives rife to the firft fpecies; being 
chiefly found in thofe that ftimulate the mucous expan¬ 
sion of the ftomach with fpirits, and whofe livers are de¬ 
ranged in confequence of the fame habit. Its appear¬ 
ance differs in the following particulars from the prece¬ 
233 
ding fpecies. In addition to an eruption of fmall fuppu¬ 
rating tubercles, there is alfo a (hilling rednefs, and an 
irregular granulated appearance of the (kin of that part 
of the face which is affeCted. The rednefs commonly 
appears firft at the end of the nofe, and afterwards 
fpreads from both fides of the nofe to the cheeks, the 
whole of which, however, it very feldom covers. In 
the commencement it is not uniformly vivid ; but is pa¬ 
ler in the morning, and readily increafed to an intenfe 
red after dinner, or at any time if a glafs of wine or fpi¬ 
rits be taken, or the patient be heated by exercife, or by 
fitting near a fire. After fome continuance in this ftate, 
the texture of the cuticle becomes gradually thickened, 
and its furface uneven or granulated, and variegated by 
reticulations of enlarged cutaneous veins, with fmaller 
red lines ftretching acrofs the cheeks, and fometimes by 
the intermixture of fmall fuppurating vari, or pimples, 
which fucceflively arife on different parts of the face. 
This fpecies of Ionthus feldom occurs in early life, 
except where there is an hereditary predifpofition to it ; 
in general it does not appear before the age of forty ; 
but it may be produced in any perfon by the conftant 
immoderate ufe of wine and fpirituous liquors. The 
greater part of the face, even the forehead and chin, are 
often affeCted in thele cafes; but the nofe efpecially be¬ 
comes tumid, and of a fiery red colour; and, in ad¬ 
vanced life, it fometimes enlarges to an enormous fize, 
the noftrils being diftended and patulous, or the alse fif- 
fured, as it were, and divided into feveral feparate lobes. 
At that period of life too, the colour of the pimples be¬ 
comes darker and more livid ; and, if fuppuration take 
place in any of them, they ulcerate unfavourably, and 
do not readily a(Tume a healing difpofition. In young 
perfons, however, who are hereditarily predifpofed to 
this complaint, irregular red patches not unfrequently 
appearin the face, which are often fmooth and free from 
tubercles, and fometimes throw off (light exfoliations at 
intervals. Thefe patches may be gradually extended, if 
great temperance both in food and drink be not obferved, 
until the whole face afl'ume a preternatural rednefs. 
As this eruption is chiefly fympathetic of fome de¬ 
rangement of the chylopoi'etic vifeera, or of a peculiar 
irritability of the ftomach, little advantage can be ex¬ 
pected from local applications : and, in fad, the ftimu- 
lants, which are beneficial under proper regulations, in 
the other forms of Ionthus, are generally prejudicial 
in this, and aggravate the complaint. We (hall not enter 
into any particular directions for the treatment of this 
complaint. Since this is fo obvious, the firft objeCt to 
be attained is to induce the patient toabftain from drink¬ 
ing, feldom an Cafy talk ; and, this being accomplilhed, 
an abftemious diet and mercurial alteratives will be the 
principal remedies to be depended on. Dr. Bateman 
fays the fymptoms may be fometimes palliated by the li¬ 
quor potaffas, or other antacids, which feem alfo to have 
fome influence in leffening inflammatory aCtion in the 
(kin. If the inflammation fubfides, the gentled reftrin- 
gents (hould be ufed externally to the patches of reticu¬ 
lated veins;-fuch as very dilute fpirituous or acetous 
lotions, with or without a fmall proportion of the ace¬ 
tate of lead, or Ample ointments combined with alum, 
acetate of lead, &c. in fmall quantities. 
Genus V. Phlyfis, [from (p\vu, to boil up, to bubble.] 
Whitlow. Generic characters—Ulcerative fubcutaneous 
tumour; flat, tenfive, glabrous, dift'ufed, hot, throbbing ; 
at length fluctuating with an acrid ichor. There is but 
one fpecies. 
Phlyfis paronychia : feated about the nails and ends 
of the fingers: pain acute and pricking; (hooting up 
the hand. Three varieties. 
a. Cutanea : the acrid eftufion feated between the (kin 
and parts immediately fubjacent. 
(?. Tendinis: eft'ufion feated between the tendons and 
the periofteum. 
y. Perioftii, 
