PATHOLOGY. 
*. V. lenfc'iformis, common chicken-pox: eruption 
appearing the fecond or third day, and confiding of fmall 
red protuberances, not exaCtly circular, and having a flat 
(hining furface, in the centre of which a minute veficle 
is foon formed : this, on the fecond day of its appear¬ 
ance, is generally feen fir A on the bread and back, af¬ 
terwards on the face and extremities; difappears about 
the tenth day, leaving red marks on the lkin, without de- 
preflion. 
( 3 . V. coniformis, conoidal chicken-pox, or fwine-pox : 
veficles acuminated : fluid pellucid throughout. 
y. V. globularis, the hives: veficles globular and 
larger 5 fluid at firfl whey-coloured, afterwards yellowifli. 
The varieties are fometimes intermixed ; and the fluid 
in a few of them occafionally approaches to a purulent 
appearance ; whence in various indances they may have 
been miflaken for the fmall-pox. It mud be recoileCted, 
however, that the pudules and veficles do fometimes rife 
into one another, or that pus and ferum may be pro¬ 
duced by different degrees of the dime aftion ; fo that 
the diftinCtion in quedion is not to be depended on. Our 
readers are well aware, that fome have inferred that 
varicella is a modification of the fmall-pox ; and Dr. 
Bateman has thought proper to give fome credit to this 
opinion. In a note on Varicella, p. 208 of his Synopfis, 
he fays, “Since the introduction of vaccination, confi- 
derable differences of opinion have exided among medi¬ 
cal practitioners, refpeCting the character of the eruption, 
which has occafionally appeared, after expofure to vari¬ 
olous infeCtion, in perfons previoufly vaccinated, fome 
denominating it chicken-pox and others fmall-pox. The 
mod careful obfervers mud have admitted the difficulty 
of edablifhinga decifive didinCtion in many of thefe cafes. 
A feries of intereding obfervations which have lately 
been made at Edinburgh, have led the ingenious Prof. 
Thomfon to believe that the chicken-pox itfelf is in faCt 
a fecond and modified fmall-pox. While the quedion is 
ftill fub judice, I leave Varicella in its nofological feat ; 
but many faCts crowd upon my own recollection, which 
incline me to believe that this fuggedion will ultimately 
prove to be correCt.” 
The information that has been obtained on this head 
fince Dr. B. wrote, has been highly corroborative of 
Prof. Thomfon’s views; but, as the queftion is by no 
means at reft, we fhall follow the above great authority 
in leaving Varicella in its “ nofological feat.” The rea¬ 
der may confult on this head the Edinburgh Med. and 
Surgical Journal, 1818. and a variety of papers of recent 
dates in the London Medical Journal. The following 
are the ufual diagnoftic marks laid down between thefe 
difeafes. 
Varicella may be diftinguifhed from fmall-pox by, 1. 
The appearance, on the fecond or third day from the 
eruption, of the veficles full of ferum at the top of the 
pock. The pudules which are fulled of the yellow li¬ 
quor referable what the genuine fmall-pox are on the fifth 
or fixth day, efpecially when there happens to be a larger 
fpace than ufual occupied by the extravafated ferum. It 
happens to mod: of them, either on the firft day the little 
veficle arifes, or on the following, that its tender cuticle 
is burft: a thin fcab is then formed on the top of the 
pock, and the fwelling of the other part abates without 
the formation of pus as in fmall-pox. 2. Slight fcabs 
cover the chicken-pox on the fifth day, at which time the 
fmall-pox are not at their height. 3. The inflammation 
round the chicken-pox is very fmall, and the contents 
of them do not feem to be owing to fuppuration as in the 
fmall-pox, but rather to what is extravafated immedi¬ 
ately under the cuticle by the ferous veffels of the fkin 
over a common blifter. No wonder, therefore, that this 
liquor appears fo foon as on the fecond day ; and that, 
upon the cuticle being broken, it is prefently fucceeded 
by a thin fcab. Hence, too, no fear is left. 
Varicella is a difeafe which is by no means dangerous, 
and which affeCts a perfon but once in his life. No other 
277 
treatment is required than the cooling regimen, mild 
aperients, and faline draughts. 
5. Emphlyfis pemphigus, veficular or bladdery fever : 
veficles fcattered over the body; tranfparent, filbert- 
fized; with a red inflamed edge, but without furround¬ 
ing blufli or tumefaction ; on breaking, difpofed to ulcer¬ 
ate ; fluid pellucid or (lightly coloured; fever a typhus. 
Three varieties. 
а. P. vulgaris: veficles appearing on the fecond pr 
third day, occafionally not till the fifth or fixth ; in fuc- 
ceflive crops ; often extending over the mouth and intef- 
tinal canal ; fluid, on burfting, yellowifli; fome of the 
veficles livid, with a livid bafe. 
/?. P. glandularis, (P. contagiofus, Willan :) preceded 
by tumefaCtion of the neck and throat 5 veficles chiefly 
feated on the fauces and conglobate glands; occafionally 
producing abfeefles ; highly contagious. 
y. P. infantum: veficles irregularly oblong, with livid 
edge, and commonly flattened tops; appearing fucceflively 
on different parts of the furface, in infants a few days 
after birth ; fluid; on breaking, purplifli. 
Pemphigus is found, for the moil part, as a fymptom 
only in eryfipelas, typhus, plague, and other deprefling 
fevers. Dr. Good doubts whether Pemphigus is enti¬ 
tled to be confidered as a diftinCt and idiopathic difeafe ; 
and whether all its varieties and modifications may not 
refolve themfelves into certain peculiarities of eryfipelas, 
or pompholyx, the latterof which confifts of fimilar vefi¬ 
cles or bulla; without fever, or mere fymptoms of typhus 
or plague. Dr. Cullen feems to have been of the laft 
opinion at the moment of drawing up his definition : but 
the fourth edition of his Synopfis contains a note which 
intimates that his opinion was altered in confequence 
of his having feen a patient, fhown him by his excellent 
colleague F. Home, and who was labouring under this 
difeafe as an idiopathic affeCtion at the time. And when 
to this inftance (fays Good) “ we add the authority, not 
merely of the earlier writers, Bontius, Seliger,- and 
Langhans, but of Withers, Dickfon, Chriftie, Ring, and 
Braune, (Uber den Pemphigus, Leipf. 1795.) it would be 
unpardonable not to allow it a diftinCt place in a general 
fyftem of nofology.” 
Notwithftanding this firing of authorities, it may rea- 
fonably be doubted that idiopathic Pemphigus ever ex- 
iffed. In Dr. Bateman’s Synopfis this opinion is adopted 
from a review' of all the authors above quoted ; and in 
this it is fhown that the accounts they have given are 
highly vague and unfatisfaCtory. 
6. Emphlyfis eryfipelas, St. Anthony’s fire : vefication 
diffufe; irregularly circumfcribed ; appearing on a parti¬ 
cular part of the body, chiefly the face, about the third 
day; with tumefaction and erythematic blufh; fever 
ufually accompanied with fleepinefs, often with delirium. 
This admits of two varieties. 
ot,. Locale: limited to a particular part; the cuticle 
railed into numerous aggregate diftinCt cells ; or the cells 
running into one or more blebs, or large blitters. 
б . Erraticum : travelling in fucceflive patches from 
part to part; the former patches declining as new ones 
make their appearance. 
Eryfipelas, which feems to occur twice over in Dr. 
Good’s arrangement, has been already referred to another 
divifion of this work. 
Genus III. Empyefis , [i. e. fuppuration.] Puftulous 
eruption. Generic characters—Eruption of phlegmo¬ 
nous pimples; gradually filling with a purulent fluid; 
and terminating in thick fcabs, frequently leaving pits or 
fears. But one fpecies. 
Empyefis variola, fmall-pox : puftules appearing from 
the third to the fifth day, fuppurating from the eighth to 
the tenth ; fever a cauma ; contagious. The fmall-pox 
confifts of the following four varieties. 
a. V. difereta, diftinCt or natural fmall-pox : puftules 
pea-fized ; diftinCt, diftended, circular; the intervening 
fpaces 
