PATHOLOGY. 
ftill require a great deal of attention. It will ftill be ne- 
ceffary to avoid heat and a heating regimen, and to con¬ 
tinue to admit the free accefs of cool air, although the 
more aCtive applications of cold, by fponging or affufion 
with water, need not be continued. At this period of 
the difeafe, it may alfo be neceflary, in adult and pletho- . 
ric fubjeCts, to take away fome blood. This, however, 
feldom requires to be repeated. But a cooling purgative 
fhould be adminiftered and repeated, or aided by a fre¬ 
quent repetition of laxative clyfters ; and the free ufe of 
diluent drinks fhould be permitted. 
Opium, which has been very much ufed in fmall-pox, 
does harm in its early ftages. In the later periods of the 
difeafe, however, when the febrile excitement is low, and 
much irritation is kept up by the hardening crufts, the 
moderate ufe of opiates is to be recommended. 
The fecondary fever, as it is called, occurs about the 
eleventh day, upon the complete fuppuration of the pul- 
tules, or at leaft when thefeare perfectly full and ftretched 
to their utmoft extent. The bowels fhould be treated by 
gentle purgatives provided no diarrhoea has occurred. 
According to the ftate of the pulfe, and the appearance 
of the matter in the eruptions, the ftrength of the pa¬ 
tient, and other fymptoms, more or lefs of a cordial plan 
of treatment mult, however, be combined with the lax¬ 
atives. Light liquid nourifhment, with a little wine 
and water as drink, fhould be frequently adminiftered ; 
and an infufion of cinchona, with the mineral acids, will 
be given with advantage. If the difeafe put on a more 
malignant character, with petechias and hsemorrhages, the 
fame treatment mull be continued. Under this cordial 
plan, the petechiae will fometimes difappear; the empty 
veficles will become filled with matter ; and the ichorous 
fluid of others be changed into white thick pus; the 
other fymptoms of courfe improving in a fimilar degree. 
If the fever becomes complicated with inflammation 
of the head, cheft, bladder, or indeed of any other part, 
the ufual meafures for its removal are to be ufed. To 
prevent as much as poflible the deformity of pitting, 
which fucceeds fmall-pox, about the tenth day of the 
difeafe we fhould fpread over the face a mafk of fine old 
cambric, thinly fmeared with a mild liniment compofed 
of oil, fpermaceti, and a little wax. This mafk may be 
renewed three or four times in twenty-four hours, and 
fometimes oftener. An agreeable and refrefliing cool- 
nefs is felt for fome time after each application ; and, the 
apices of the puftules not being fuffered to dry and 
harden, pitting is prevented in a great meafure. 
Small-pox very rarely attacks the fame individual 
twice. For inftances, however, fee the article Small¬ 
pox. 
Genus IV. Anthracia, [from an 9 p«|, a hot coal.] Car¬ 
buncle, or Plague-fore. Generic characters—Eruption 
of tumours imperfectly fuppurating, with indurated 
edges, and for the mot part a fordid and fanious core. 
There are two fpecies. 
i. Anthracia peftis, (Lcemus, Greek Authors.) Plague : 
tumours bubonous, carbunculate, or both ; appearing 
at an uncertain time of the difeafe $ fever a malignant 
typhus, with extreme internal heat and debility ; conta¬ 
gious. 
The precife fituation which Peftis fhould occupy in 
the nofological fcale is a matter about which authors have 
been divided. Dr. Good gives it a place among the ex¬ 
anthems, becaufe “ the fever is fpecific, like that of all 
the exanthems ; it is contagious, like that of molt of 
them ; and, although capable of occurring oftener than 
once in a man’s life, we have the concurrent teftimony 
of all the writers who have been eye-witnefles of its ef¬ 
fects, that it renders him lefs fufceptible for a confiderable 
period afterwards. The eruption of buboes or carbun¬ 
cles is unqueftionably a pathognomonic fymptom: the 
fluid they fecrete is capable of producing the difeafe by 
inoculation ; for the moft part, the earlier they make 
Vol. XIX. No. 1303. 
279 
their appearance the better; and it is the opinion of M. 
Sotira, and moft of the French medical ftaff appointed 
to the Egyptian expedition, that, provided the bubo 
freely fuppurates, the patient receives an indemnity for 
life- It is true, indeed, that thefe tumours do not always 
appear in their proper or perfeCt character ; for fometimes 
the patient is deftroyed by the violence of the firft fymp¬ 
toms ; and in other inftances, as in fmall-pox, the fpe¬ 
cific fever pafles through its courfe with an imperfeCt or 
trivial fructification ■, but, unlefs there be an aCtual ger¬ 
mination, or what Sauvages calls a conatus, a perfeCt or 
an imperfeCt epanthefis, we have no right whatever to 
call the difeafe a plague, and can only regard it as a 
fpecies or variety of fynochus, or typhus. It has three 
varieties. 
a. P. fruCtifera: the difeafe extending to about the 
fourteenth day ; and relieved by the appearance of the 
eruption. 
j 3 . P. infruCtifera: eruption imperfeCt or fuppreffed 
transferred to fome internal organ ; or fuperfeded exter¬ 
nally by ftigmata and vibices. 
y. P. erythematica: the body covered over with 
trails of veficular erythema, producing deep fanious and 
gangrenous ulcerations as it fpreads, often to the lofs of 
one or more limbs. 
For the beft defcription of this variety of Peftis, Dr. 
Good refers us to the pages of Thucydides, who de- 
fcribes it from having been an eye-witnefs of its ravages, 
and a fufferer under them j or to thofe of Lucretius, 
who has copied the account with clofe and technical 
punctuality. The following paflage from the latter may 
ferve to illuftrate this remark. De Rer. Nut. lib. vi, 
1152. But we give it in the tranflation : 
Forth pour’d the breath moft fetid from the mouth. 
As fleams the putrid carcafe : every power 
Fail’d through the foul, the body, and alike 
Lay they liquefcent at the gates of death : 
While with thefe dread, infufferable ills, 
A reftlefs anguifli join’d, companion clofe. 
And fighs commixt with groans ; and hiccough deep. 
And keen convulfive twitchings ceafelefs urg’d, 
Day after day, o’er every tortur’d limb. 
The wearied wretch ftill wearying with aflault. 
Yet ne’er too hot the fyftem couldft thou mark 
Outwards, but rather tepid to the touch ; 
Ting’d ftill with purple dye, and brandifh’d o’er 
With trails of cauftic ulcers like the blaze 
Strew’d by the holy fire. But all within 
Burn’d to the bone : the bofom heav’d with flames 
Fierce as a furnace, nor would once endure 
The lighted veil thrown loofely o’er the limbs. 
The extraordinary length of this article, and the va¬ 
rious and affeCting, though not ftriCtly pathological, de¬ 
tails which the hiftory of Plague exhibits, induces us to 
defer our account of the malady in queftion till we come 
to the article Plague. 
1. Anthracia rubula, the yaws: tumours numerous 
and fucceffive j gradually increafing from fp'ecks to the 
fize of a rafpberry j one at length growing larger than the 
reft: core a fungotis excrefcence ; fever flight ; occurring 
only once during life $ contagious. Two diftinCt va¬ 
rieties. 
a. R. Guineenfis, Guinea yaw: attacking infants and 
young perfons chiefly ; and fubfiding as foon as the 
eruption appears. 
( 3 . R. Americana, American yaw: depafcent ■, and 
deftroying progreflively both mufcles and bones; efpe- 
cially the mafter-yaw, which is called mamanpia. See 
Yaws. 
Order IV. Dysthetica, [from I am ill.] 
Cachexies. “Morbid ftate of blood or blood-veffels 
alone or connected with a morbid ftate of other fluids 
producing a difeafed habit.” 
4 c 
This 
