CHAP. VI.
Of the Small-Pox.
From what has been said of the Nature of Malignant and Pestilential Diseases it will follow, that the Contagious Matter producing the Small-Pox does likewise Coagulate the Blood, and increase the Bulk of its constituent Particles, and that in such a Proportion as are capable of obstructing only the ultimate and perspirable Vessels, as appears, in that it principally, if not solely affects the membranous Parts of the Body, as well External as Internal. Now these Parts being formed of such Vessels, the Pustules could not happen in these more than other Parts of the Body, were not their Vessels thus obstructed, and obstructed they cou'd not be, but from the increased Bulk of the Sanguineous Particles, and that in such a Proportion as renders them capable of penetrating into, but not passing thro' the Cavities of the ultimate Vessels, as appears from the preceeding Propositions, and consequently, the contagious Matter producing the Small-Pox, must be indued with this peculiar Property. And indeed if we allow the different Degrees of Coagulation in these Contagious Diseases, and which appear even to our Senses, it will appear, that the Principal if not the sole Difference proceeds only from the greater or less Bulk and Number of the Coagulated Moleculæ, and Acrimony of the Coagulating Matter. Thus we see that in Pestilential Diseases, where the Degree of Coagulation and Acrimony of the Juices are superior to the rest, the Obstructions happen in the larger Glands, as are those of the Armpits, Groin, &c. The Circulation of the Blood being obstructed, or at lest much retarded in the Capillary Blood Vessels, as appears from the weak Pulse, Coldness of the Extremities, and the like, which constantly accompany it; And consequently the Moleculæ form'd by the Coagulation of the Animal Juices must be larger, than these in the Small Pox, which proceed to the ultimate Vessels before the Obstructions are formed. The Measles are another Confirmation of this Theory, whose Moleculæ are still less than the preceeding, as appears by their Eruption with greater Flatness, and less Extension of the Obstructed Vessels. Thus also we see that in all these Diseases where the Contagious Matter is more Virulent than ordinary, or the Constitution of the Year more productive of these Diseases, or join'd with a Hot Tense and Scorbutic Disposition, Diarrhea's, Dysenteries, Purple Spots, Hemorrhages, Phrensies, Convulsions, Inflammations, &c. equally accompany these as Pestilential Diseases.
From what has been said in this and the foregoing Chapters may be deduced the Reasons of the greater or less Virulency of the Small-Pox, Measles, &c. in some Years more than others; As also why these Diseases shou'd rage with the greatest Violence when join'd with, or immediately preceeding a Pestilential Constitution of the Air. Hence also appears the Reason why Pains of the Head, Stomach, Loins and Back, preceed the Eruption of the Pustules, these Parts as nearest the Heart being soonest obstructed, and the Impetus of the Blood against the obstructed Canals much greater than in the rest of the Body. As also why the Pustules should appear so much sooner in the Face, Neck and Breast, than other Parts of the Body, as appears from Prop. 2.
Hence likewise appears the Reason why the Fever, Vomiting, Pains, &c. preceeding the Eruption of the Pustules should cease or be much diminish'd upon their Appearance; The Moleculæ, by the Force of the Circulating Fluids, being driven into and fixt in the Cutaneous Glands, and Secretory Vessels, whereby the Capillary Arteries being freed from them, a more easy Passage is allowed to the Circulating Fluids. Hence also appears the Reason why the Fever gradually increases with the Augmentation of the Pustules, the Contiguous Vessels being compress'd by their Distention, and the Obstructions in the Secretory Vessels made more Numerous; whence the Quantity of the Perspirable Matter being Diminished, and the Canals streightned, the Vessels will be more full, and the Pulse more strong and frequent. Hence likewise it will follow, that the more numerous the Obstructions are, and more pungent the Contagious Matter, the more Violent the Symptoms will be, and the Matter of the Pustules when suppurated become an Acrid and pungent gleety Substance, or Laudable Pus. As also why the Time of Suppuration shou'd vary in Proportion to the Virulency of the obstructing Matter; and consequently the Reason of the Difference between the Distinct and Confluent Small-Pox. Hence also it will appear, that Bleeding, in the Beginning of the Disease, ought only to be Administred where the Impetus of the Circulating Fluids is so great, that notwithstanding the Diminution of the Force of the Blood by it, the protrusive Force of the Circulating Mass will exceed the Impetus made on the Obstructing Matter by the Vibrations of the Fibres, and likewise why on its imprudent Use in the Beginning of the Disease, the Pustules shou'd disappear, and be driven back into the sanguineous Vessels. Hence also may be deduced the Reason of the Flux by the Salival Glands, the Swelling of the Face, Hands, and Feet, in the height of the Disease, the Vessels being at this time Turgid by the Suppression of the perspirable Matter; And likewise the Necessity of such Evacuations, as may reduce the Pressure of the Fluids upon them to such a Proportion, as the Tone of the Fibres may be able to resist; And why where this is neglected, a Peripneumonia, Phrensy, Delirium, &c. do frequently succeed.
Lastly, Hence may be deduced the Reason why the Small-Pox shou'd rarely seize those twice, who have had a Competent Number of them. For the Ultimate Perspirable Vessels being distended much beyond their Natural Tone, by the Bulk of the Obstructing Moleculæ, the Secretory Vessels must be left wider than before, and consequently less subject to be obstructed by Particles of this Size; Agreeable to this is that Observation of Dr. Sydenham and others, That in those Constitutions of the Air where the Small-Pox were very Epidemic, many (especially such as attended the Sick) who before had been affected with this Disease, were seized with a Fever in all Respects the same with that attending the Small-Pox, except only the Eruption of the Pustules, and the Symptoms which necessarily attend on them.