276 
PATHOLOGY. 
tie laxative, with light and cooling diet, (with total ab- 
ftinence from fermented liquors, and from fudorific me¬ 
dicines,) conftitute the foie treatment which appears to 
be requisite for the fafe condudt of thefe diforders to 
their period of decline; at which time the cinchona, with 
fulphuric acid, is beneficial. 
Genus II. Emphlyfis, [from tp for sv, within, and 
$>Avcr»;, a veficular tumour or eruption.] Ichorous erup¬ 
tion from internal fever. Generic characters—Eruption 
of veficular pimples filled progreflively with an acrid and 
colourlefs, or nearly colourlefs, fluid} terminating in 
fcurf or laminated fcabs. There are fix fpecies. 
i. Emphlyfis miliaria, the miliary fever: veficles 
fcattered over the body ; of the fize of millet-feeds } 
tranfparent red, afterwards milky; preceded by a prick¬ 
ing fenfation, fighing, anxiety, and four fweat. 
The veficles are at firft red, from the colour of their 
under furface, or inflamed bafe, being tranfmitted 
through the tranfparent pellicle; they are afterwards 
opaite and milky, from abforption of the more attenuate 
part of the fluid, or from fome other change. This af¬ 
fection, which is a mere fymptom of inflammatory fever, 
generally owes its exiftence entirely to the hot and ftimu- 
lating practice of our forefathers. In the prefent im¬ 
proved practice, it is fcarcely ever feen ; and it requires 
no particular treatment. 
i. Emphlyfis aphtha, the thrufh : veficles granular, 
roundifh, pearl-coloured; confined to the lips, mouth, 
and inteftinal canal; terminating in curd-like floughs ; 
occafionally with fucceflive crops. Two varieties. 
a. Aphtha infantum, white thrufh : appearing in in¬ 
fants foon after birth; and often extending from the 
mouth to the inteftinal canal; moftly with flight febrile 
fymptoms, and white floughs. 
£. Aphtha maligna, black thrufh : accompanied with 
great debility of vafcular aCtion ; ufually afcending from 
the pharynx into the mouth ; floughs black; fever a ty¬ 
phus. 
To forbid improper diet, prefcribe gentle laxatives, 
and occafionally the warm bath, and to caufe a weak fo- 
lution of borax to be applied to the fauces, conftitutes 
all that is neceflary for the treatment of Aphtha in¬ 
fantum. 
The fecond variety (hows itfelf at firft by an uneafy 
fenfation or burning heat in the ftomach, which comes 
on by flow degrees, and increafes gradually in violence. 
After fome time, fmall pimples, of about the fize of a 
pin’s head, appear on the tip and edges of the tongue ; 
and thefe at length fpread over the whole infide of the 
mouth, and occafion fuch a tendernefs and rawnefs of 
the parts, that the patient cannot take any food of a folid 
nature; neither can he receive any vinous or fpirituous 
liquor into his mouth, without great pungency and pain 
being excited. Little febrile heat attends, but the fkin 
is always remarkably dry and without the leaft moifture 
on it; the countenance is pale, the pulfe is fmaller and 
more languid than in health, and a general coldnefs is 
felt over the whole body, but more particularly in the 
extremities. 
This complaint is always combined with chronic gaf- 
tritis, of which it is probably a mere fymptom ; and it re¬ 
quires the fame treatment, with the addition however of 
gargles. 
3. Emphlyfis vaccinia, cow-pox : veficles few, or a An¬ 
gle one, confined to the part affe&ed ; circular, femitranf- 
parent, pearl-coloured ; depreffed in the middle, fur- 
rounded with a red areola. Four varieties. 
a. V. nativa, natural cow-pox : veficles on the hands, 
or fuch parts as have been in contact with the affefted ud¬ 
der of a cow; of abluifhtint; the fluid at firft limpid ; 
afterwards opake, and purulent; often with enlargement 
of the axillary glands, and confiderable fever. A pro¬ 
phylactic againlt the fmall-pox. 
£. V. fpuria, fpurious cow-pox : veficles lefs uniformly 
circular; purulent from the firft; without bluifti tint}, 
with little or no central depreflion. Affords no fecurity 
againft the fmall-pox. 
y. Inferta, inoculated cow-pox: produced by inocula-, 
tion; veficle Angle, confined to the punCture; cellulofe;, 
bluifh-brown in the middle ; fluid clear and colourlefs to 
the laft; concreting into a hard dark-cloured fcab after 
the twelfth day. 
3 . V. degener, degenerate cow-pox: produced by 
inoculation ; veficle amorphous, or uncertain; fluid 
often ftraw-coloured, or purulent; areola abfent, in- 
diftinCt, or confufed with the veficle; fcab formed pre¬ 
maturely. Affords little or no fecurity againft the fmall- 
pox. See the article Inoculation, vol. xi. 
Since the time at which that article was compofed, much, 
very much, has been written on the fubjeCt of vaccina¬ 
tion. But, though fome interefting circumftances of its 
origin, and the vaft extent of the world to which it has 
travelled, have been made known, yet we look in vain 
through the long lift of reports, from the molt illuftrious 
bodies of the profeflion, of cafes, with which our perio¬ 
dicals have fo long teemed, and even through entire trea¬ 
ties on vaccination, for one new practical faCt. In a 
work of this kind it may be neceflary, however, that we 
fliould give our teftimony in favour of vaccination; left, 
if it fliould fall into the hands of fome whofe prejudices 
are in oppofition to the ufe of Jenner’s difcovery, our 
filence fliould be conftrued into difapprobation of it. 
And this is the more neceflary, becaufe, in fome of the 
early articles of this work, vaccination has been fpoken 
of in a flight manner. Its value was not then known, as 
its efficacy was not eftablilhed. But we can no longer 
withhold our conviction of its great benefit in the majo¬ 
rity of cafes. We have now the fupport of the higheft 
authorities in ftating, 1. That vaccine matter, duly in- 
ferted under the fkin, is capable of preventing the fu¬ 
ture occurrence of the fmall-pox. 2. That this matter 
requires a very fmall degree of concentration, but that 
it is liable to degeneration from chemical changes when 
removed from the body, and alfo while in the fore if it, 
be taken at an improper time. 
Many exceptions exift to the firft rule. If the patient 
be afflicted with any cutaneous defaedation, the vaccina¬ 
tion will be generally ineffedfual. In many cafes fmall- 
pox will come on after cow-pox, notwithftanding the ut- 
nioft precaution, from peculiar idiopathy of habit or 
conftitution ; and this happens in a far greater proportion 
of cafes than the occurrence of fmall-pox twice ever happened , 
But fo mild is it under thefe circumftances, that vacci¬ 
nation might be confidered one of the kindeft grants 
ever conferred by Providence on man, did it never effect 
any tiling more than this modifying operation ; for, even 
in that cafe, we fliould poflefs in the vaccine procefs all 
the advantages without any of the evils that are confefif- 
edly appended to variolous inoculation ; and the writer 
muft indulge the hope that neither the apprehenfions of 
the timid, nor the wrong-headednefs of the obftinate, 
will operate to any confiderable extent, in encouraging 
the re-introduCtion of the latter practice. The fword for 
ages fufpended over us has been blunted to the extent of 
almoft entire liarmleffnefs ; and it were fully amounting 
toinfanity, to polifli it ourfelves into its priftine power. 
And, when it is confidered that by far the majority of 
vaccinated perfons do not take fmall-pox under any cir¬ 
cumftances of expofure or even of inoculation ; when it 
is confidered, alfo, that in thofe countries where vacci¬ 
nation is enforced, fmall-pox no longer exifts ; we cannot 
but view the prejudices againft it as a great ftigma on 
our national character. 
4. Emphlyfis varicella, the chicken-pox : veficles fcat¬ 
tered over the body ; glabrous, tranfparent, pea-fized ; 
in fucceflive crops 5 pellicle thin ; about the third day 
from their appearance, burfting at the tip, and concreting 
into fmall puckered fcabs, rarely leaving a cicatrix. 
There are four varieties of this fpecies noted by Dr. Good. 
