The latter, or miliaria inirritata, was attended with great arterial debility; and during the course of the fever pellucid points appeared within the skin, particularly on the soft parts of the fingers. And, in one patient, whom I esteemed near her end, I well recollect to have observed round pellucid globules, like what are often seen on vines in hot-houses, no larger than the smallest pins' heads, adhere to her neck and bosom; which were hard to the touch, but were easily rubbed off. These diseases, if they are allied, do not differ more than the kinds of small-pox; but require many further observations.
The eruption so often seen on children in the cradle, and called by the nurses red-gum, and which is attended with some degree of fever, I suspect to be produced by too great warmth, and the contact of flannel next their tender skins, like the miliaria sudatoria; and like that requires cool air, cool clothes, and linen next their skin.
[13]. Pestis. The plague, like other diseases of this class, seems to be sometimes mild, and sometimes malignant; according to the testimony of different writers. It is said to be attended with inflammation, with the greatest arterial debility, and to be very contagious, attended at an uncertain time of the fever with buboes and carbuncles. Some authors affirm, that the contagion of the plague may be repeatedly received, so as to produce the disease; but as this is contrary to the general analogy of all contagious diseases, which are attended with fever, and which cure themselves spontaneously; there is reason to suspect, that where it has been supposed to have been repeatedly received, that some other fever with arterial debility has been mistaken for it, as has probably universally been the case, when the small-pox has been said to have been twice experienced.
M. M. Venesection has been recommended by some writers on the first day, where the inflammation was supposed to be attended with sufficient arterial strength, which might perhaps sometimes happen, as the bubo seems to be a suppuration; but the carbuncle, or anthrax, is a gangrene of the part, and shews the greatest debility of circulation. Whence all the means before enumerated in this genus of diseases to support the powers of life are to be administered. Currents of cold air, cold water, ice, externally on the hot parts of the skin.
The methods of preventing the spreading of this disease have been much canvassed, and seem to consist in preventing all congregations of the people, as in churches, or play-houses; and to remove the sick into tents on some airy common by the side of a river, and supply them with fresh food, both animal and vegetable, with beer and wine in proper quantities, and to encourage those who can, daily to wash both their clothes and themselves.
The pestis vaccina, or disease amongst the cows, which afflicted this island about half a century ago, seems to have been a contagious fever with great arterial debility; as in some of them in the latter stage of the disease, an emphysema could often be felt in some parts, which evinced a considerable progress of gangrene beneath the skin. In the sensitive inirritated fevers of these animals, I suppose about sixty grains of opium, with two ounces of extract of oak-bark, every six hours, would supply them with an efficacious medicine; to which might be added thirty grains of vitriol of iron, if any tendency to bloody urine should appear, to which this animal is liable. The method of preventing the infection from spreading, if it should ever again gain access to this island, would be immediately to obtain an order from government to prevent any cattle from being removed, which were found within five miles of the place supposed to be infected, for a few days; till the certainty of the existence of the pestilence could be ascertained, by a committee of medical people. As soon as this was ascertained, all the cattle within five miles of the place should be immediately slaughtered, and consumed within the circumscribed district; and their hides put into lime-water before proper inspectors.
[14]. Pemphigus is a contagious disease attended with bladdery eruptions appearing on the second or third day, as large as filberts, which, remain many days, and then effuse a thin ichor. It seems to be either of a mild kind with sensitive fever only, of which I have seen two instances, or with irritated, or with inirritated fever, as appears from the observations of M. Salabert. See Medical Comment, by Dr. Duncan, Decad. II. Vol. VI.
[15]. Varicella. Chicken-pox is accompanied with sensitive fever, pustules break out after a mild fever like the small-pox, seldom suppurate, and generally terminate in scales without scars. I once saw a lady, who miscarryed during this disease, though all her children had it as slightly as usual. It sometimes leaves scars or marks on the skin. This disease has been mistaken for the small-pox, and inoculated for it; and then the small-pox has been supposed to happen twice to the same person. See Trans. of the College London. It is probable that the pemphigus and urticaria, as well as this disease, have formerly been diseases of more danger; which the habit of innumerable generations may have rendered mild, and will in process of time annihilate. In the same manner as the small-pox, venereal disease, and rickets, seem to become milder or less in quantity every half century. While at the same time it is not improbable, that other new diseases may arise, and for a season thin mankind!
[16]. Urticaria. Nettle-rash begins with mild sensitive fever, which is sometimes scarcely perceptible. Hence this eruption has been thought of two sorts, one with and the other without fever. On the second day red spots, like parts stung with nettles, are seen; which almost vanish during the day, and recur in the evening with the fever, succeeded in a few days by very minute scales. See Trans. of the College, London.
[17]. Aphtha. Thrush. It has been doubted, whether aphtha or thrush, which consists of ulcers in the mouth, should be enumerated amongst febrile diseases; and whether these ulcers are always symptomatic, or the consequence rather than the cause of the fevers which attend them. The tongue becomes rather swelled; its colour and that of the fauces purplish; sloughs or ulcers appear first on the throat and edges of the tongue, and at length over the whole mouth. These sloughs are whitish, sometimes distinct, often coalescing, and remain an uncertain time. Cullen. I shall concisely mention four cases of aphtha, but do not pretend to determine whether they were all of them symptomatic or original diseases.