PATHOLOGY. 
tion, followed by puftules, ulceration, and fcabbing, on 
any portion of the found (kin, which comes into frequent 
contact with the parts difeafed : thus, in young children, 
the bread is inoculated by the chin, and the hands and 
arms by contaft with the face. The arms and bread of 
the nurfe are alfo liable to receive the eruption in the 
fame manner; but it is not fo readily communicated to 
adults as to children. 
The P. favofa requires the exhibition of the fame al¬ 
teratives, internally, as have been recommended for the 
cure of the P. cruftacea, in dofes proportioned to the 
age and drength of the patient. The diet and exercife 
fhould alfo be regulated with care : all crude vegetables 
and fruits on the one hand, and dimulating fubdances, 
whether folid or fluid, on the other, fhould be avoided ; 
and milk, puddings, and a little plain animal food or 
hroths, fhould be alone recommended. If the patient 
be of a fqualid habit, or fuffers under any flrumous af¬ 
fection, the bark and chalybeates, or the folution of mu¬ 
riate of barytes united with the former, will contribute 
materially to the redoration of health. There is com¬ 
monly fome degree of inflammation prefent, which con¬ 
tra-indicates the ufe of aCtive flimulants externally. The 
unguentum zinci, or the ung. hydrargyri prscipitati 
albi, mixed with the former, or with a faturnine oint¬ 
ment, will be preferred as external applications, efpe- 
dally where the difchargeis copious: and the ointment 
of the nitrate of mercury, diluted with about equal parts 
of Ample cerate and of the ceratum plumbi fuperacetatis, 
is generally beneficial; but the proportion of the un¬ 
guentum ceraa mud be varied according to the degree of 
inflammation. A poultice is often ufefui for the larger 
ulcerations. 
A fevere modification of this malady fometimes attacks 
the face of adults, but is eafily removed by a courfe of 
purges and by emollient poultices. 
£. P. lupinofa, dry tetter: puflules minute, in fmall 
patches, moflly commencing on the fcalp; patches ter¬ 
minating in dry delving fcabs, refembling lupine-feeds ; 
the interdices often covered with a thin whitifli exfolia¬ 
ting incrudation. Found chiefly in early life. 
This requires the fame conflitutional treatment as 
the preceding varieties. Its local treatment mud alfo 
be the fame, varying however the form of tfiefe to a due 
relation with the intenfity of the difeafe. 
s. P. furfuracea, fcurfy tetter, (fee fig. 2. Plate XI.) 
Pudules very minute, with little fluid ; feated on the 
fcalp ; terminating in fcurfy fcales. Chiefly found in 
adults. 
This variety differs from the others in the greater dry- 
nefs of its exfoliation. This aridity is often fo great a3 
to render the complaint likely to be midaken for Lepri- 
afis, or fome other of the fcaly cutaneous deffedations. 
From them it may be diftinguilhed by this circumdance ; 
viz. that fcaly difeafes are not preceded, by moifl or puitular 
eruption ; there is no moidure except what arifes from 
rupture of veffels, produced by fcratching; the hair is 
not detached ; neither are they infectious. 
The Porrigo furfuracea is often accompanied by en¬ 
largement of the glands of the throat. The treatment is 
the fame as the other varieties of Porrigo; viz, to re- 
prefs vafcular aCtion in the inflammatory ftage, and ex¬ 
cite the fecernents in the latter; which latter plan may 
be fooner put in force in this than in another variety of 
Porrigo. Dr. Good gives, as a lad variety, 
£. P. areata. This difeafe, which he fuppofes bears fome 
affinity to the Area of Celfus, the Trichofis area of this 
fyflem, or the Porrigo decalvans of Bateman, is inferted 
becaufe “the author had feen numerous indances of it, 
and often fimultaneoufly in the fame family, as though 
contagious.” It is thus defined : “ Cluders of very mi¬ 
nute puflules feated on the fcalp, in circular plots of 
baldnefs, with a brown or reddifh furfuraceous furface.” 
3; Ecpyefis efthyma: puftules large; diftinCt; diftant; 
fparingly fcattered; feated on a hard circular red bafe 5 
361 
terminating in thick, hard, dark-coloured, fcabs. There 
are three varieties; all invariably connected with confti- 
tutional difturbance.- 
a. E. vulgare (Plate XI. fig. 4.) is the flighted form 
of the diforder, and confifts of a partial eruption of fmall 
hard puftules, on fome part of the extrerpities, or on the 
neck and Ihoulders, which is completed in three or four 
days. In the courfe of a fimilar period, the puftules fuc- 
cefiively enlarge, and inflame highly at the bafe, while 
pus is formed at the apex; and in a day or two more they 
break, pour out their pus, and afterwards a thinner fluid, 
which fpeedily concretes into brown fcabs. In a week 
more, the forenefs and inflammation fubfide, and the 
fcabs foon afterwards fall off", leaving no mark behind. 
( 3 . E. infantile occurs in weakly infants, during 
the period of laClation, when an infufficient nutri¬ 
ment is afforded them. The puftules are, in appearance, 
the fame as thofe of the preceding variety, and go through 
fimilar ftages of progrefs in the fame time. But the dif¬ 
order does not terminate here : frefli eruptions of phly- 
zacia continue to rife in fucceffion, and to a much greater 
extent than in the E. vulgare, appearing not only over 
the extremities and trunk, but on the fcalp, and even 
on the face. Hence the duration of the eruption is much 
greater than in the preceding variety, being fometimes 
protraCted for feveral months. Yet the patients ufually 
remain free from fever, and the pain and irritation feem 
to be inconfiderable, except when a few of the puftules 
become very large and hard, with a livid bafe, and ul¬ 
cerate to fome depth : in this cafe, alfo, a flight whitifli 
depreflion is permanently left on the feat of the puftule. 
y. E. luridum, (fig. 5.) This differs from thepreceding 
varieties in the dark red colour of the bafe of the puftules, 
and their hard and elevated condition. Thefe puflules 
are moreover of a larger fize. The eruptions, both in 
the growth of the puftules and in the fubfequent ulcer¬ 
ation, fcabbing, and healing, is very flow in its progrefs. 
This variety is chiefly confined to advanced age. All 
the varieties of ECthyma are cured by conflitutional 
treatment. In the two firft varieties, improvement in 
the diet of the patient and gentle purges and alteratives, 
will in a fliort time effeCl a cure. In the E. luridum, a 
more comprehenfive fyflem of praftiee mud be embraced; 
and, viewing the difeafe as fymptomatic of a broken-up 
conftitution, our endeavours mud be directed to the ge¬ 
neral ftate of health,, and the removal of the cacheCtic 
diathefis. We have already fufficiently treated of this 
under jyyfpepfia. 
E. cacheCticum. Mod authors deferibe ano¬ 
ther variety of EClhyma. It is omitted by Dr. Good, 
probably becaufe it may be doubted whether it be not a 
confequence of fiphilitic or other morbid poifon. We 
are inclined to think it is; but, according to Dr. Bate¬ 
man, this is not invariably the cafe. It is thus deferibed 
by that author. “ The diforder ufually commences with 
a febrile paroxyfm, which is fometimes confiderable. In 
the courfe of two or three days, numerous fcattered puf¬ 
tules appear, with a hard inflamed bafe, fometimes firft 
on the bread, but mod commonly on the extremities: 
and thefe are multiplied day after day by a fucceffion of 
fimilar puftules, which continue to rife and decline for 
thefpace of feveral weeks, until the Ikin is thickly ftudded 
with the eruption, under various phafes. For, as the 
fucceflive puftules go through their ftages of inflamma¬ 
tion, fuppuration, fcabbing, and defquamation, at fimilar 
periods after their rife, they are neceffarily feen under all 
thefe conditions at the fame time; the riling puftules ex¬ 
hibiting a bright red hue at the bafe, which changes to 
a purple or chocolate tinge, as the inflammation declines, 
and the little laminated fcabs are formed upon their tops: 
when thefe fall oft’, a dark ftain is left upon the fite of the 
puftules. In different cafes the eruption varies in its 
diftribution : it is fometimes confined to the extremities, 
where it is either generally diffufed, or cluftered in irre¬ 
gular patches; but it frequently extends alfo over the 
2 trunk, 
