356 
PATHOLOGY. 
and-of inflammation round their bafes. There are three 
varieties. 
a. P. benignus, water-blebs: blebs pea-fized or fil- 
1 ert-fized ; appearing fucceffively on various parts of 
ti.e body; burfting in three or four days, and healing 
readily. 
| 3 . P. diutinus, (fig. 2. Plate IX.) Blebs gradually 
growing from fmali veficles to the fize of walnuts; yel- 
lov.ifh; often fpreading in fuccefiion over the whole body, 
and interior of the mouth ; occafionally reproduced, and 
forming an excoriated furface with ulcerations. Often 
preceded by languor or other general indifpofition for 
feveral weeks. Duration from two to four or five months. 
This difeafe chiefly affefts perfons of debilitated ha¬ 
bits ; and is very fevere in the aged. It feerns to origin¬ 
ate under different conditions of the body, but often 
after continued fatigue and anxiety, with low diet; fome- 
times from intemperance; and not unfrequently it is 
connected with anafarca, or general dropfy, with fcurvy, 
and other dates of the conftitution, in which the powers 
of the cutaneous circulation are impaired. It is mod 
troublefome and obftinate in old perfons, in whom the 
tranfparent bullae fometimes equal the fize of a turkey’s 
egg, while others of a ftnaller fize are intermixed with 
them, which appear dark and.livid. When broken, they 
leave a black excoriated furface, which fometimes ulcer¬ 
ates. The warm bath, ufed every fecond day, was confi- 
dered by Dr. Willan as the mod active palliative, and tire 
bed remedy. Bateman has feen the decodtion of cin¬ 
chona, with cordials and diuretics, of coniiderable ad¬ 
vantage in thefe cafes, efpecially when the eruption was 
combined with anafarca. In young perfons in whom 
the pompholyx is feldom fevere, thefe remedies are af¬ 
firmed by Dr. Willan to be fuccefsful within two or 
three weeks; but the warm bath feerns to increafe both 
the tingling in the fkin, and the numbers of the vefica- 
tions, in thefe patients. 
•y. P. quotidianus : blebs with a dark red bafe, appear¬ 
ing at night and dilappearing in the morning. Found 
chiefly in the hands and legs. Vandermonde relates a 
cafe in which the acceflions were reverfed; the blebs ap¬ 
pearing in the morning, and difappearing at night. 
P. folitarius : folitary ; but reproductive in an ad¬ 
joining part; the bleb very large, and containing a tea¬ 
cup full of lymph. Preceded by tingling, often accom¬ 
panied with languor. This is a rare form of the difeafe, 
and feerns to affedt only women. Cinchona internally, 
and linfeed poultices, followed by light drefiings to the 
fores externally, were employed with advantage in three 
cafes feen by Dr- Willan. 
2. Ecphlyfis herpes, tetter: eruption of veficles in 
fmali diftindl clufters ; with a red margin ; at firft pellu¬ 
cid ; afterwards opake; accompanied with itching or 
tingling ; concreting into fcabs. Duration from four¬ 
teen to twenty-one days. Here we have fix varieties. 
a. H. miliaris, (Plate IX. fig. 3.) Veficles millet-fized : 
pellucid ; clufters commencing at an indeterminate part 
of the furface, and progreflively ftrewed over the body ; 
fucceeded by frefli crops. It is commonly preceded by a 
flight febrile attack for two or three days. The fmali 
tranfparent veficles then appear, in irregular clufters, 
fometimes containing colourlefs, and fometimes a brown- 
i(b, lymph; and for two or three days more, other cluf¬ 
ters fucceffively arife near the former. When very mi¬ 
nute, they fpread extenfively; but, if at maturity they 
attain a conftderable fize and an oval form, we feldom 
lee more than two or three clufters together ; and fome¬ 
times there is only a fingle chiller. The included lymph 
fometimes becomes milky or opake in the courfe of ten 
or twelve hours ; and about the fourth day the inflam¬ 
mation round the veficles affumes a duller red hue, while 
the veficles themfelves break, and difcharge their fluid, 
or begin to dry and flatten, and dark or yellovvifti fcabs 
concrete upon them. Thefe fall off about the eighth or 
tenth day, leaving a red-dened and irritable furface, 
which flowly regains its healthy appearance. As the 
fucceffive clufters go through a firnilar courfe, the termi¬ 
nation of the whole is not complete before the thirteenth 
or fourteenth day. 
( 3 . H. exedens, nirles: veficles hard ; of the fize and 
origin of the laft ; clufters thronged ; fluid denfe, yellow, 
or reddifh ; hot, acrid, corroding the fubjacent lkin, and 
fpreading in Terpentine trails. 
This difeafe is rare ; and we know not on what autho¬ 
rity Dr. Good lias ftated that the nirles is the fame dif¬ 
eafe as that defcribed by Galen, from whom his defini¬ 
tion is derived. We fubjoin Dr. G.’s abftradt of Galen’s 
opinion : “ Herpes, according to Galen, is an eruption 
of minute and crowded veficl es, of thejizeof millet-feeds, 
excited on the furface of the lkin, filled with an acrid bi¬ 
lious fecretion ; and conlifts of two fpecies; the one con¬ 
taining in its veficles a milder and more aqueous fluid, 
called from the fize of the veficles Herpes miliaris, which 
merely fcems to burn, or corrode ; the other containing 
a thicker fluid of a higher heat and colour, and fo acrid as 
actually to corrode the continuity of the fubjacent lkin, 
ftill creeping along in a ferpentine direction, as the term 
herpes imports,"and hence denominated by Hippocrates 
Herpes ejlhiomenos .” 
y. H. zofter : fhingles: veficles pearl-fized ; the cluf¬ 
ters fpreading round the body like a girdle: at times 
confluent. Occafionally with general irritation or other 
conftitutional affedtion ; being ufually preceded for two 
or three days by languor and lofs of appetite, rigors, 
liead-ache, ficknefs, and a frequent pulfe, together with a 
fcalding heat and tingling in the fkin, and fliooting pains 
through tiie cheft and epigaftrium. Sometimes, however, 
the precurfory febrile fymptoms are flight, and fcarcely no¬ 
ticed ; and the attention of the patient is firft attracted by a 
fenfe of heat, itching, and tingling, in fome part of the 
trunk, where he finds feveral red patches of an irregular 
form, at a little diftance from each other, upon each of 
which numerous fmali elevations appear, cluftered toge¬ 
ther. Thefe, if examined minutely, are found to be dif- 
tindfly veficular; and, in the courfe of twenty-four 
hours, they enlarge to the fize of fmali pearls, and are 
perfectly tranfparent, being filled with a limpid fluid. 
The clufters are of various diameter, from one to two, 
or even three, inches, and are furrounded by a narrow 
red margin, in confequence of the extenfion of the in¬ 
flamed bafe a little beyond the congregated veficles. 
During three or four days, other clufters continue to 
arife in fuccefiion, and with confiderable regularity; that 
is, nearly in a line with the firft, extending always to¬ 
wards the fpine at one extremity, and towards the fter- 
num, or linea alba of the abdomen, at the other, moft 
commonly round the waift like half a fafh, but fometimes 
like a fword-belt acrofs the fhoulder. 
While the new clufters are appearing, the veficles of 
the firft begin to lofe their tranfparency, and on the 
fourth day acquire a milky or yellowifh hue, which is 
foon followed by a bluifh or livid colour of the bafes 
of the veficles, and of the contained fluid. They now 
become fomewhat confluent, and flatten 5 r fubfide, fo 
that the outlines of many of them are nearly obliterated. 
About this time they are often broken, and for three or 
four days difcharge a fmali quantity of a ferous fluid ; 
which at length concretes into thin dark fcabs, at firft 
lying loofely over the contained matter, but foon be¬ 
coming harder, and adhering more firmly, until they fall 
off about the twelfth or fourteenth day. The furface of 
■the (kin is left in a red and tender ftate; and, where the 
ulceration and difcharge have been confiderable, nume¬ 
rous cicatrices or pits are left. As all the clufters go 
through a firnilar feries of changes, thofe which ap¬ 
pear lsteft arrive at their termination feveral days later 
than the firft 5 whence the difeafe is fometimes protradfed 
to twenty or even twenty-four days, before the crufts 
exfoliate. In one or two inftancesthe veficles have been 
known to terminate in numerous fmali .ulcers, or fuppu- 
rating 
