Inoculated Small Pox. Between seven and nine days, some slight fever succeeded by an eruption of pustules; in general not numerous, and the patients are very seldom confined to bed, or indisposed. In ninety-nine cases out of an hundred, inoculation produces a distinct small pox, void of danger. After inoculation from the maturated pustules of real small pox, and the usual symptoms of impregnation, mankind are ever after invulnerable by this contagion.
Chicken Pox. Bastard or spurious; and distinguished under the apellation of petite verole volante, stein pox, and swain pox. They are sometimes epidemick, but inoffensive; and have given rise to the supposition of a person’s undergoing the natural small pox a second time. The eruption forms very quickly into pustules, of which the pus is not concocted, nor tenacious; and after three or four days, incrustations.
Measles.
Morbilli rubeola. From 100 to 120th part of the community seem to be destroyed by measles. Morbillous mortality is to that of small pox in the ratio of one to ten or twelve; and consequently may be estimated at one of seventy-seven whom it attacks. Sydenham, long ago observed, that measles, if judiciously treated, are attended with very little danger; but he should at least have qualified the expression, by adding immediate and considerable danger; for both immediately, and in their future consequences, they are by no means so innocuous. Few escape this exotick contagion, especially in childhood and in cities. It attacks the same persons but once in life; and, with us, is said to be most epidemick in winter.
Morbillous symptoms are fever, impaired appetite, heaviness of the head and eyes, somnolency, catarrh, acrid defluxion from the fauces, nose, and eyes, with hoarseness, sneezing, and lachrymation; short dry cough, and some difficulty in respiration. Prior to the eruption, there is generally anxiety about the breast, palpitation of the heart, itching of the face, peevishness, and considerable fever. On the third or fourth day there is an eruption of small red spots first on the face, resembling the bites of ants or fleas, generally confluent and entangled, and broad on the trunk and extremities; but not elevated above the skin, nor rising into pustules, nor suppurating: the size and shape various and irregular. About the sixth day the eruption on the face begins to dry, and on the ninth, is totally obliterated with desquamation of the cuticle. With the eruption the fever frequently does not cease; and the cough and difficulty in respiration often continue beyond the eruptive limits and cuticular desquamation. The usual crisis is by scaling of the cuticle, turbid urine, or diarrhœa. Unfavourable symptoms are, too sudden or too tardy eruption; pale or yellow eruption; great debility; and above all, pulmonick inflammation. The last in the train of morbillous evils and consequences are, consumption, anasarca, ophthalmy. Sometimes, though rarely, measles have been seen in accompanyment with other eruptive fevers, as small pox, and gangrenous angina.
Scarlet fever.
Febris scarlatina, ignis facer, scarlatina anginosa. Its mortality in the London bills is added to the general febrile heap. This contagious epidemick is most frequent in the infant and adolescent age; it attacks families and schools about one time; and the same person but once in life; and is said to be most frequent in winter. It is generally accompanied with an anginous or ulcerous sore throat, but not putrid. That genus or species of scarlet fever which usually accompanies angina gangrenosa, and is extremely dangerous, is hereafter described. The symptoms of simple scarlet are the usual febrile precursors; on the second, third, or fourth day, an eruption of broad irregular redness and spots; general or partial only over the face, trunk, and extremities, and not elevated above the surface: sometimes overspreading the face with a crimson colour. Concomitant symptoms are, difficulty of swallowing, and uneasiness in the throat, redness, tension, and sloughs: commonly also nausea, sickness at the stomach, vomiting, vertigo, drowsiness, headach, difficulty of breathing, anxiety. After three or four days more; that is, between the sixth and ninth, the cutaneous eruption and redness disappears, with desquamation of the cuticle, and harrassing pruriency. The usual crisis is by sweats, urine, fetid stools, and exscreation of sloughs. Sometimes, a few days after the cuticular desquamation, an anasarcous swelling suddenly appears; and during the convalescent state, from exposure to cold air, or neglect of cutaneous and other expurgation, anasarca, hydrothorax or ascites have ensued.
There are two or three other febrile eruptions to which authors have appropriated distinct names, but by which very few of the human race are destroyed. These are febris urticata, bullosa, and pemphigodes. In general, they consist of red spots and serous vesicles on different parts of the skin, exciting heat and itching; the urticata resembling blisters from the burning of nettles. Some of these are mobile, receding and re-appearing, and prone to relapse. After a few days, however, or at the utmost a few weeks, they vanish: and are not contagious nor epidemick.