POX
(8^)
POX
Matter in them well concocted, of a whitifli Colour in- clined to yellow; at which time, 8. The Patient is ufually light-headed and feverifh. o. About the tenth day the Puflules begin to dry on the Face. 10. And about the fifteenth they appear fhrunk, and begin to fcale off; and now the danger is etteem'd to be over.
The diftintt kind is here confidcr'd unattended with a Loofeneis, and other Symptoms, which fomctimes happen in it, as well as in the other.
P'he Confluent, or Flux Small Pox have the fame Symp- toms with the diflinH, only in a more violent degree : They ufually come out on the third day ; not feparate, as in the diflinB kind, but fpread into one another ; and at length appear all like one whitifli Pellicle, over the whole Skin. Atrer the eighth day, the Pellicle darkens. In Adults this kind is attended with a Salivation ; in Chil- dren with a Diarrhea. The Salivation frequently fucceeds immediately after Eruption ; the Diarrhoea later. The Cw$tierit kind ufually kill on the eleventh day.
The Symptoms of the Confluent kind, according to Dr. Shaw, are, I. Violent Pain in the Head, Back, and Scro- biculum Cordis. 1. Naufea and Retching, with a Fever, which rather increafes than decreafes after the Eruption. 5. In Children a Diarrhasa, which ufually precedes the Eruption, and attends the Diftemper throughout. 4. A Ftyalifmus inAdults, and but feldom a Diarrhoea. 5. Deliria, Convulsions, Hoarfenefs, Difficulty of Breathing, Fixednefs of the Eyes, and Reftleflhefs ; which may alfo in a lefTer degree attend the diflinB fort. 6. The Spots are here more red, thick, and dole than in the diflinB ; and the Spaces between them more inflamed and fwell'd ; purple or livid Spots alfo often appear in thefe Spaces; whence the Small "Pox with 'Purples. At other times in thefe Spaces, or on the Heads of the Eruptions, appear Bladders full of clear Water, vulgarly call'd the white Hives. Laftly, thefe Eruptions are frequently deprefs'd in the middle 5 and there turn black ; whence the black Small 'Pox.
The Eruptions often rife and fink in the Progrefs of the Diftemper. They ufually firft appear about the fourth or fifth day, and come to their State about the fifteenth.
Morton divides the Difeafe into four Stages : The Ap- paratus or Preparation, from the time of the firft In- fection to the Eruption of the Puftles. The Eruption, which comprehends three States : Eruption ; Maturation', tm&.'Declcnfion, wherein the Puftles are firft incruftated with a Scab, then wither and dry off.
When the-Eruptions are very round, diftinft, encompafs'd with a red Margin, &c. they are faid to be benign ; otlfer- wife malignant.
There are four degrees of Malignancy : viz. when they are university confluent ; particularly confluent ; diftinct, but very fmall and coherent; and diftinfl, with Petechia; and miliary Eruptions. See Petechia, £j?c.
Dr. Friend, Dr. Cade, &c. recommend Purging and Phle- botomy after an imperfect Crifis of the Small Pox ; i.e. where the Fever remains after the Puftles decline. Many oppofe it : Indeed Rcafon feems on its fide ; but Pre- fcription is again!! it.^ Alfaharavius, in the firft Stage of the SmallPox, prefcribes Phlebotomy, even to a Swoon- ing, and great Quantities of cold Water to be drunk. In the malignant SmaWPox, Dr. iLifler found the Blood,when cold, exceffively tender and friable, fo as the fofteft Feather would eafily divide its Globules. Etmuller fays there is no- thing to be_ more regarded than the Breath and Voice ; where thefe ate good, 'tis an excellent Sign. He adds that Horfe-Dung is an admirable Medicine, in that it promotes Sweat, favestheThroar, X$c.
A Method of managing the Small Pox, lately introduced from abroad, is by Inoculating them. For the Reafon, •procefs, and Advantages whereof, feelNocuLATioN.
Why the SmallPox fcarce ever vifit a Perfon above once, is a famous Problem ; long canvafs'd, and with little fuccefs. Dr. Drake accounts for it very plaufibly from the Alteration made in the Skin by that Difeafe. For the Diflenfion the Glands and Pores of the Skin fuffer therein is fo great, that they fcarce ever recover their Tone again, fo as to be able any more to arreft the Matter in its Courfe outwards long enough, or in quantity enough, to create thofe Ulcerous Puftles which are the Diagnoffies of the Difeafe. For tho the fame feverifh Difpofition fhould arife again in the Blood, yet the Paffagcs thro' the Skin being more open, the Matter will never be ftop'd, fo as to exhibit the Ap- pearance of the SmallPox.
Accordingly we find that in Perfons feverely handled with this Difeafe, the Face (which is ufually the fulleft, from the extraordinary obflruction the Matter meets with-by the great Contlipation of the Pores) feldom returns to its former Dimensions ; which Enlargement he accounts for from the Dilatation of the Areola of the Glands and Pores of the Skin, not from any Augmentation of the Subftance itfelf.
What confirms this Hypothefis, is, that Nurfes, He.
who attend Perfons tick of the Small Pox, are frequently* little afTeflcd with it ; and have now and then two or three Eruptions : That they have no more, feems to fel- low from the free Courfe of the Matter thro' the Skin. With this, too, agrees that conftant Obfervation, That People of coarfe Skins, in whom the Pores are largcft, are always more favourably treated by this Diftemper 'than others; and that it conftantly leaves fine Skins coarfer than it found 'em.
This Solution would feem more probable, were it not that fome have fo very few of thele Eruptions, perhaps not above twenty or thirty ; which cannot fairly be allow'd fo fir to enlarge the Pores of the Skin.
Others hold, That in a genuine Eruption, the Caufe of the Diftemper is fo far evacuated, as fcarce to leave a poffi- bility of a Return ; and that if part of the original Caufe did remain behind, it might, when the Air favours it, or when by other Accidents 'tis fecreted from the Blood, ap- pear in the form of Eruptions, and fo prove to be the Meafles, Chicken-Pox, £$c.
It may, indeed, be objefled, that thefe laft mention'd often happen before the 'Small 'Pox .- But whatever be the Caufe of the Small Pox, the feparating Power mutt be in fuch a determined Proportion, or it will fail to caufe a re- gular Small Pox ; and fo ailing proportionably, may pro- duce any of the other Diftempers juft mentioned.
The occaponal Caufes of the Small Pox may be, 1. So me Alteration in the Air ; fince they happen moft frequently about the Spring Seafon ; and both in Europe, and elfe- where, are more Epidemical and Mortal at particular times, a. From Fear; which appears more evident than eafy to explain. 3. From Surfeits, as by eating any thing too chilling to the Blood, as Cucumbers, Oranges, i$c. in hot Seafons, or when the Body is heated by Motion, the drinking of cold Liquors. 4. From too plentiful feeding. 5. From any over-heating the Blood, or too fuddenly cool- ing it after it is heated, whereby a fudden Check is given to Perfpiration ; and this more efpecially if the Air favours fuch an Eruption.
As to the prognoftic Signs of the Small Pox; 1. The fooner they appear in the Spring, and the more the Air is difpofed to favour the Diftemper, the more fatal they prove. 2. The confluent Species both in Adults and Chil- dren, is dangerous ; and the more fo, if attended with a fuppreffion of Urine, Naufea, Retching, Delirium, purple Spots, Cryftallines, bloody Urine, £fJc. after the Eruption ; but the blacknefs of 'em is not dangerous before the Crifis. 5. Diarrhaia's in the confluent kind, are not fo bad in Chil- dren as in Adults. 4. A Ptyalifmus is a regular Attendant of the confluent kind in Adults from the fixth or feventh day till after the Crifis ; and is fo neceflarv, that if it flop fuddenly, and return not for twenty four Hours, the Patient is fuppofed to be in great danger. 5. A Quincy here is highly dangerous. 6. The Eruptions fwelling, and finking fuddenly, are bad Signs. 7. The danger is not over til? about the twentieth day in the confluent Species. But if the Eruptions be diftinct, few, round, plump, rife full and grow upfharp at the top ; if the Sicknefs, Vomiting' gfc. gooff, or remit upon the appearance of the Eruptions' and the Patient be under no dreadful Apprehenfions ; the danger is ufually over about the tenth da'y in the diftinfl kind. Convulfions attending the firft Symptoms of the SmallPox in Children, are faid to forefhew the appearance of Eruptions within twelve Hours ; which then generally prove diftinfl, and the Patient does well. ThcSmall 1'om Succeeding a Debauch in Liquors, or happening upon an irregular Courfe of Life, is ufually mortal.
Chicken POX, a cutaneous Difeafe, frequent in Children wherein the Skin is cover'd with Puftles hke thofe of the' Small Pox, as to Figure and Magnitude ; and only diftin- gui liable therefrom, in that thofe of the Small Pox appear with a rednefs and inflammation ; and thofe of the Chicken -Pox whiter, refembling VeflcuU full of a ferous Humour ; which in three days time burft, and dry away, without any danger, and ufually without any Fever.
The ChickenPox and Swim Vox feem to be the Small Pox in a lefs degree, tho' they fome times precede and fometimes fucceed the Small Pox. The Puftles appear to be of the fame kind, only in the Swine Pox they are much larger, and in the Chicken Pox fomewhat lefs than in the Small Pox. There commonly appear five or fix fome- times twenty or thirty on the Face, and but very few on the Body. '
The Patient is very little indifpofed, either before at, or after their appearance ; tho' the fudden linking of rli'em often caufes fome diforder; but 'tis prefently relieved by a little Sack and Saffron, or a Dofe of Treacle- Water.
Grown Perfons feldom keep within Doors for either; and upon that account the Eruptions may continue the lon- ger, becaule the cold Air is fuppofed to hinder their ripe- ning; fo that 'tis fometimes three Weeks or a Month be- fore they totally difappear.
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