359 
PATHOLOGY. 
under the fame circumftances, the warm fea-water bath, 
followed by a courfe of bathing in the open fea, is pro¬ 
ductive of great benefit. But, during the exiftence of any 
aCtual inflammation, the irritation of fait water is de¬ 
cidedly injurious. 
y. I. erythematica: puftules fcattered, preceded by 
erythematic blufli and intumefcence; often by febrile or 
other conftitutional affeCtion. Chiefly in the face, neck, 
and chell. 
This variety Ihould be treated in the fame manner as 
eryfipelas. As the erythema goes off, the Ikin may be 
gently ftimulated by fulphureous orfalt-water baths, and 
bark and the acids exhibited internally. 
I. laminofa: puftules confluent; chiefly in the 
extremities; the aggregate fcabs forming a thick,.rough, 
and rigid, cafing round the affeCled limb, fo as to impede 
its motion; a thin ichor exfudingfrom numerous cracks. 
This variety requires the fame internal medicines 
w'hich have been recommended for the inveterate forms 
of the preceding varieties, efpecially the fulphureous 
waters. The chief peculiarity of its treatment confifts 
in clearing the furface of its incruftation, and correcting 
the morbid aCtion of the fuperficial vefl’els. The thick 
fcab can only be foftened, and gradually removed, by 
perfeverance in the application of the fleam of warm 
water to it, for a ftiort time, daily. Thofe parts of the 
furface, which are thus cleared, muft be covered with 
foft linen, after tepid ablution, twice a-day ; and fome- 
times the unguentum zinci, or a much-diluted ointment 
of nitrate of mercury, may be ufed. 
£. I. exedens: the purulent difcharge corroding the 
ikin and cellular membrane. Chiefly on the fide of the 
cheft or trunk. 
This rare and intraftable difeafe is at prefent fcarcely 
known. Dr. Bateman fays he had never feen an inftance 
of it. The few inftances which have been recorded have 
terminated fatally. 
£ I. localis: confined to a particular part, moftly the 
hands or fingers; and produced by external ftimulants, 
as fugar or lime. 
This variety includes thofe common forms of tetter 
excited by peculiar ftimuli : hence it comprehends the 
baker’s itch, grocer’s itch, bricklayer’s itch, and the 
the eruption arifing from fri&ion with tartarized anti¬ 
mony, &c. 
2. Ecpyefis porrigo, puftules ftraw-coloured; fluid 
vifcid ; concreting into fcales or yellow fcabs. 
There are fix varieties of this fpecies. Their claflification 
is adopted from Bateman ; but many circumftances feem 
to fliow that they are not naturally united. Mr. Plumbe 
efpecially objedts to our confidering the crufta-ladlea 
(P. cruftacea) as a variety of porrigo. Of the others it 
may be remarked, that the opinion of Willan, that each 
of thefe varieties might be produced by one another, is 
not confonant with the refults of more extended obferva- 
tion, or of diredt experiment: Small dofes of mercury 
are highly ufeful in this difeafe : the hydrargyri cum 
creta is perhaps the beft form for very young patients. 
The health of the perfon who fuckles the child fhould 
likewife be attended to. As local applications in the 
beginning of the malady, tepid ablution or the faturnine 
ointment, and afterwards, for the purpofe of flight ftitnu- 
lation, the Ung. hyd. nitrati, are all that are required. 
a. P. cruftacea, milky fcall, or tetter ; (Plate XI. 
fig. i.) Puftules commencing on the cheeks or forehead 
in patches ; fcabs often confluent, covering the whole 
face with a continuous incruftation. Found chiefly in 
infants during the period of ladlation. 
It is liable to confiderable variation in its courfe; the 
difcharge being fometimes profufe, and the furface red 
and excoriated ; and at other times fcarcely perceptible, 
fo that the furface remains covered with a dry and brown 
fcab. When the fcab ultimately falls off, and ceafes to 
be renewed, a red, elevated, and tender, cuticle, marked 
with deep lines, and exfoliating feveral times, is left 
Vol. XIX. No. 1309, 
behind ; differing from that which fucceeds to Impetigo, 
inafmuch as it does not crack into deep fiffures. Molt 
commonly, however, the difeafe terminates favourably, 
though its duration is often long and uncertain. It 
fometimes fuddenly puts on the appearance of ceffation, 
arid afterwards returns with feverity. Sometimes it 
difappears fpontaneoufly foon after weaning, or after 
the cutting of the firft teeth ; and fometimes it will con¬ 
tinue from two or three months to a year and a half, or 
even longer. It is remarkable however, that, whatever 
excoriation may be produced, no permanent deformity 
enfues. 
Q. P. galeata, (called head : puftules commencing on the 
fcalp, in diftindt, often diftant, patches; gradually 
fpreading till the whole head is covered as with a hdmet; 
cuticle, below the fcabs, red, filming, dotted with 
papillous apertures, oozing frefti matter; roots of the 
hair deftroyed : contagious. Found chiefly in children, 
efpecially during dentition. (Tinea, Alibert, Sauv. &c.) 
Sometimes a narrow border of hair is left uninjured. 
It is then called ringworm of theJ'culp ; but has no affinity 
with ringworm, properly fo called. 
The firft fymptoms of the (called head are a falling of 
fome of the hair, and an unpleafant itching of the fcalp ; 
then arife diftindt and diftant clufters of fmall yellow 
puftules, which foon break, or are broken by the child’s 
fcratching them, and form fcabs, which become thick and 
hard by accumulation. If the fcabs are removed, how¬ 
ever, the furface of the patches is left red and fhining, 
but ftudded with flight elevated points, or papula, in 
fome of which minute globules of pus again appear in a 
few days. By thefe repetitions of the eruption of achores, 
the incruftations become thicker, and the areas of the 
patches extend, often becoming confluent, if the progrefs 
of the difeafe be unimpeded, fo as to afFedt the whole 
head. As the patches extend, the hair covering them 
becomes lighter in its colour, and fometimes breaks off 
fhort; and, as the procefs of puftulation and fcabbing is 
repeated, the roots of the hair are deftroyed, and at length 
there remains uninjured only a narrow border of hair 
round the head. 
Such is the defcription of (called head as it occurs in 
this country. In France we fee much more violent 
fymptoms ; as the following defcription, taken from 
Alibert, fufficiently indicates. “ The individuals affedted 
with tinea, generally feel, at firft, a pruritus, more or 
lefs violent, on the head. The fcalp, on certain points 
of its furface, next becomes red, chaps, or even becomes 
a little tumefied. A fwelling of the cervical glands 
fometimes accompanies the complaint, more rarely a 
head-ache. The itching daily increafes; and puftules or 
veficles are feen furrounded by an inflamed areola. In 
fome cafes no trace of ulceration can be perceived, a 
reddifh vifcid humour appearing to exude from the 
dilated mouths of the glandular follicles. Prefently the 
hair becomes agglutinated by this vifcid humour, which 
iffues, flow after flow, refembling melted rofin, forming 
cruft upon cruft of fcabby or fcaly layers, horrible and 
difgufting to behold ! Meantime a putrid fanies beneath 
corrodes the hairs even to their bulbs, deftroys the 
neighbouring cellular tiflue, and threatens the cranium 
itfelf. Some of thofe afflidled fall a prey to violent noc¬ 
turnal pains ; others into a ftate of emaciation which 
entirely arrefts their growth. It is more efpecially when 
tinea is congenital, or its treatment neglected, that it 
commits fuch dreadful ravages. It is then that we fed 
abfcefles form in the fcalp; glandular fwellings in the 
occiput, neck, flioulders, and armpits; immenfe-en¬ 
largements of the ears; rednefs, lacrymation, irritation 
of the eye-lids; difgufting odour from the confluent 
puftules; falling of the hair; torpor and inaptitude of 
the intelledls; defeat of phyfical power; even of the 
generative procefs.” 
The difeafe feems to originate fpontaneoufly in children 
of feeble and flabby habit, or in a ftate approaching to 
4 Z marafinus, 
