35? 
PATHOLOGY. 
rating foramina, which continued to difcharge for many 
days, and were not all healed before the end of the fourth 
week. The febrile fymptoms commonly fubfide when 
the eruption is completed; but fometimes they continue 
during the whole courfe of the difeafe, probably from 
the incefl'ant irritation of the itching and fmarting con- 
nefled with it. In many inftances, the moll diftrefllng 
part of the complaint is an intenfe darting pain, not fu- 
perficial, but deep-feated in the cheft, which continues 
to the latter ftages of the difeafe, and is not eafily al¬ 
layed by anodynes: fometimes this pain precedes the 
eruption. 
Herpes zofter is not contagious. Its caufes are not 
very obvious : it is moft frequently traced to pulmonic, 
gaftric, or inteftinal, irritation, and is commoneft in fpring 
and autumn. As it pafles through its regular ftages 
fpontaneoufly and invariably, it never requires any thing 
to be done, except to adopt a cooling regimen. 
S. H. circinatus, ring-worm ; (fig. 4.) velicles with a 
reddifii bafe, uniting in rings ; the area of the rings 
(lightly difcoloured ; often followed by frefh crops. 
This is a very flight affedlion, being unaccompanied 
with any diforder of the conftitution. It appears in fmall 
circular patches, in which the veficles arife only round 
the circumference: thefe are fmall, with moderately red 
bales, and contain a tranfparent fluid, which is dif- 
charged in three or four days, when little prominent 
dark fcabs form over them. The central area, in each 
veficular ring, is at firft free from any eruption; but the 
furface becomes fomevvhat rough, and of a dull red co¬ 
lour, and throws off an exfoliation, as the veficular erup¬ 
tion declines, which terminates in about a week with 
the falling off of the fcabs, leaving the cuticle red for a 
fhort time. The whole difeafe, however, does not con¬ 
clude fo foon: for there is commonly a fucceflion of the 
veficular circles, on the upper parts of the body, as the 
face and neck, and the arms and flioulders, which have 
occasionally extended to the lower extremities, protradl- 
ing the duration of the whole to the end of the fecond 
or third week. No inconvenience, however, attends the 
eruption, except a difagreeable itching and tingling in 
the patches. 
The herpetic ringworm is moft commonly feen in chil¬ 
dren, and is deemed contagious. Another form of H. 
circinatus fometimes occurs, in which the area of the 
circles is covered with clofe-let veficles, and the whole is 
furrounded by a circular inflamed'border. The veficles 
are of a conliderable fize, and filled with tranfparent 
lymph. The pain, heat, and irritation, in the part, are 
very diftrefling ; and there is often a confiderable confti- 
tutional difturbance accompanying the eruption. One 
duller forms after another in rapid fucceflion on the face, 
arms, and neck, and fometimes on the day following on 
the trunk and lower limbs. The pain, feverilhnefs, and 
inquietude, do not abate till the fixth day of the eruption, 
when the veficles flatten, and the inflammation fubfides. 
On the ninth and tenth days a fcabby cruft begins to form 
on fome, while others dry and exfoliate; the whole 
difeafe terminating about the fifteenth day. 
£. H. iris, (fig. 5.) occurs in fmall circular patches, 
each of which is compofed of concentric rings of differ¬ 
ent colours. Its ufual feat is on the back of the hands, 
or the palms and fingers, fometimes on the inftep. Its 
firft appearance is like an efflorefcence; but, when it is 
fully formed, not only the central umbo, but the fur¬ 
rounding rings, become diftindtly veficular. The patches 
are at firft fmall, and gradually attain their full fize, 
which is nearly that of a fixpence, in the courfe of a week 
or nine days, at the end of which time, the central part 
is prominent and diftended, and the veficular circles are 
aifo turgid with lymph ; and, after remaining nearly fta- 
tionary a couple of days, they gradually decline, and en¬ 
tirely difappear in about a week more. The central ve- 
ficie is of a yellowifh white colour; the firft ring fur¬ 
rounding it is of a dark or brownifli red ; the fecond is 
nearly of the fame colour as the centre; and the third, 
which -is narrower than the reft, is of a dark red colour; 
the fourth and outer ring, or areola, does not appear un¬ 
til the feventh, eighth, or ninth, day, and is of a light 
red hue, which is gradually loft in the ordinary colour 
of the fkin. 
£. H. localis, (Herpes labialis, H. prteputialis, &c. 
Bateman.) Seated on a particular organ, chiefly the lip 
and prepuce, and not migratory. Very little attendance 
is required in herpetic difeafes. They generally run their 
career without being either fliortened or delayed by it. 
There is often, however, fome conftitutionaldifturbar.ee 
accompanying the various forms, which it may be of con- 
fequence to attend to, according to the appearance of 
the eruption and the feelings of the patient. Aftr-in- 
gents and anodyne lotions may be ufed ; but they muft 
be regulated by the general principles already laid down 
at the head of this order. 
3. Ecphlyfis rhypia ; (Rupia, Bateman.) Eruption of 
broad, flattifh, diilindl veficles; bafe (lightly inflamed ; 
fluid fanious; fcabs thin, and fuperficial; eafily rubbed 
off and reproduced. Three varieties. 
a. R. fimplex ; fcab flat; livid or blackilh : the fubja- 
cent fkin of the fame hue. 
( 3 . R. prominens ; fcab elevated and conical like a lim¬ 
pet’s (hell; rapid in its progrefs, and fucceeded by an ulcer. 
Thefe varieties of Rupia are to be combated by lup- 
porting the fyftem, by means of good, light, nutritious, 
diet, and by the ufe of alterative and tonic medicines; 
fuch as Plummer’s pill, cinchona, and farfaparilla. The 
firft is reprefented by fig. 1. Plate X. the fecond by fig. 
2. of the fame engraving. 
y. R. efcharotica : fanious difcharge erofive, produ¬ 
cing gangrenous efehars. 
4. Ecphlyfis eczema, heat-eruption : eruption of mi¬ 
nute acuminated veficles, diftinft, but clofely crowding- 
on each other, pellucid or milky ; with troublefome itch¬ 
ing or tingling; terminating in thin fcales or fcabs ; oc¬ 
cafionally furrounded by a bluftiing halo. Chiefly pro¬ 
duced by the heat of the fun; and moftly attacks the 
hands and other parts that are principally expofed to its 
rays. 
The eruption is fucceflive, and has no regular period 
of duration or decline : it commonly continues for two 
or three weeks, without any particular internal diforder. 
The included lymph becomes more milky, and is gradu¬ 
ally abforbed, or dried into browmifti fcales, which exfo¬ 
liate, or into brownifli yellow fcabs, of the fize of a fmall 
pin’s head, efpecially when the veficles are broken. But 
fucceflive eruptions of the veficles are apt to appear, 
which terminate in a fimilar manner by exfoliation or 
(cabbing; and in thofe perfons who, by the peculiar irri¬ 
tability of their Ikin, are much predifpofed to the difor¬ 
der, it is thus continued many weeks, to the end of au¬ 
tumn, or even prolonged to the winter. When this 
happens, the veficles generally pour out an acrid ferum, 
by which the furface is inflamed, rendered tender, and 
even flightly ulcerated, and the difeafe afl'umes the form 
of Impetigo. 
The courfe of this diforder does not appear to be ma¬ 
terially fliortened by the operation of medicine. The 
mineral acids, with adecoflion of cinchona, or other ve¬ 
getable tonic, and alight but nutritious diet, feem to be 
moft eftedlual in diminifliing the eruption. When it has 
occurred after long-continued travelling, or any other (e- 
vere fatigue, and appears to be accompanied with fome 
degree of exhauftion of the powers of the conftitution, 
a courfe of ferpentaria, or farfaparilla, is exceedingly 
beneficial. Adtive and repeated purgation is adverfe'fto 
the complaint. Simple ablution with tepid water, con¬ 
tributes to relieve the fmarting and tingling of the parts 
affedted; but they do not bear unguents, or any ilimu- 
lant application. 
Genus 
