fnake-root, the contrayerva-root, faffron, afa foetida,

myrrh, and the like. laid on all the limbs.

But above all, blifters must be
Such is the neceffity of fome

evacuation or other in this disease, that if the matter of the infection be over-abundant, as it happens in bad cafes, nature never fails endeavouring to. throw off the load. Thus in adults a fpitting comes on upon the first days of the eruption; whereas children, who feldom fpit, have a looseness almost through the whole disease. Both thefe evacuations are of great importance; and therefore, as the loofenefs is not to be inconfiderately stopped in children; fo in adults, if the spitting does not go on to our wifhes, it ought to be promoted by medicines, which ftimulate the glands of the mouth; efpecially gargles made of a decoction of mustard-feed and pepper, with the addition of oxymel. For in the confluent and malignant finall-pox, if this flux does not arife, and even continue to the end of the difeafe, it is a very bad fign.

Sometimes a fuppreffion of urine makes the patient fuffer great pain, receiving little or no relief from diuretics. In this cafe Dr Sydenham directed, that he fhould be taken out of bed, and expofed to the cool air which generally has a good effect. But the moft convenient method will be to open the body by a clyfter, especially if, the puftules now appearing, there be any fear of taking cold; and then to infift a little on diuretic medicines; for which purpose Glauber's falt is particularly ufeful, as it is both la xative and diuretic.

?

Whenever a woman with child is feized with the fmall-pox, the physician may justly dread the confe quences, For he has reafon to fear a mifcarriage,

which exposes his patient to two forts of danger, the one from the new fever, which attends that accident; the other from the lofs of blood, which may bring her very low. And therefore the farther the is advanced in her pregnancy, the greater rifk fhe runs; because the delivery of a large child caufes a greater flooding than that of a final one. I can however affert from my own knowledge, that a certain woman was delivered of a fon at the full time, while she was actually labouring under this difeafe;' and yet both the mother and the child did well; but this is a cafe equally extraordinary and fortunate. But ftill a good deal depends on the time of the dif eafe, when the abortion happens: because the weaknefs occafioned thereby is the more dangerous, the more nearly it coincides with the time of the ripening of the puftules. Wherefore, if the efflux be more than nature ufually requires, thofe medicines are to be given, which I have proposed in the bloody fmallpox.

Now, whereas thefe cafes fall out various ways, and physicians have been divided in opinion concerning fome of them; it may not be improper to make fome animadverfions on them feparately.

When a woman in the fmall-pox fuffers abortion, the child most commonly comes into the world with the distemper on it; but not always. The reafon of this difference will eafily be understood, by duly confidering what I have already faid concerning infection, and comparing it with what I fhall hereafter fay concerning the inoculation of the finall-pox t. Whereby it will plainly appear, that the feeds of the Chap. i. + Chap. v.

VOL. II.

T

difeafe

disease are fubtile particles, exhaled from the puftules come to maturity; which do not produce the effect, till eight or nine days after their entrance into a found body. Upon which account, when the child comes into the world, before matter is made in the puftules on the mother, it has no visible marks of the distemper. And thus it fometimes happens, that the smallpox, which the infant has contracted in the womb, breaks forth on the fecond, third, or any other day before the eighth from the delivery, whether the child be come to its full time or not; as will appear by the following cafe, which lately fell under my own obfervation.

A lady of quality was, in the feventh month of her pregnancy, feized with fo malignant a fort of the confluent fmall-pox, that there was no appearance of any one favourable fymptom. For fhe neither spit plentifully; nor did the fwelling of the hands or feet come on, upon that of the face fubfiding; nor, in fine, was fhe affifted by a flux of urine on the decline of the disease; but, on the contrary, her face was all covered with fmall pimples, which made little or no matter. In this condition, fhe was, on the eleventh day of the diftemper, pretty easily delivered of a fon, who brought no marks of the infection into the world; and he died on the fourteenth day. But in the morning of the fourth day following, the infant was feized with convulfions, the forerunners of the eruption, which appeared the fame day, and he died in the evening. In this cafe it is plain, that fome fuppuration having been made, as ufual, on the eleventh day, the diftemper paffed from the mother

to

to the child, which was not to break out till eight days after.

But in cafe there is no mifcarriage, the child will be free from the difeafe during his whole life; unless he happens to be born before the puftules were come to maturity. For as fomething naturally inherent in our conftitution renders the body liable to the infection; fo, when this debt is once paid to nature, we are fecure ever after. But the infant in the womb fometimes catches the diftemper, without the mother being affected; as I fhall prove by this remarkable inftance, which I well remember. A certain woman, who had formerly had the fmall-pox, and was now near her reckoning, attended her husband in the diftemper. She went her full time, and was delivered of a dead child. It may be needlefs to obferve, that fhe did not catch it on this occafion but the dead body of the infant was a horrid fight, being all over covered with the puftules; a manifeft fign that it died of the disease, before it was brought into the world. Wherefore, upon the whole,. let none entertain the leaft fufpicion, that the fame perfon can poffibly have this diftemper twice. But the reafon why the body is liable to the infection once, and no more, is to me as entirely unknown, as to the moft ignorant of mankind. But this I will add, that an infant in the womb may have the good luck to go through the disease, and yet the marks be quite effaced before the birth *.

:

From what we have faid concerning abortions, it is eafy to comprehend what judgment ought to be formed of the monthly evacuations coinciding with * Vid. Mauriceau, fur la groffeffe & l'accouchement des femmes, obf. 576.

the fmall-pox, a circumftance at which people are apt to be alarmed. For this evacuation is of the fame kind with the flooding which follows upon abortion and whether it happens at the ufual time, or is brought on irregularly by the extraordinary effervefcence of the blood; in both cafes, it rather affords relief than threatens danger. However, if in either cafe the discharge should prove fo great, as to weaken the patient over-much; it must be reftrained by thofe medicines which I have recommended in the bloody fmall-pox, without neglecting to draw blood, if requifite. But we know by experience, that womenhave fometimes uterine difcharges through the whole courfe of the difeafe, without lofs of ftrength, or any other inconvenience.

The fame judgment may be formed of hæmorrhages at the note, which frequently occur in the beginning of the diftemper; for they are occafioned by the rarefaction of the blood in the fmall veffels; and therefore, by diminishing the heat, are generally more ferviceable than detrimental, unlefs they run to excefs.

It happens fometimes, though not often, that the variolous fever is accompanied with a fingle or double tertian intermitting fever; in which cafe, the Peruvian bark, or, which is more convenient, its extract, is to be given at proper diflances of time, till the paroxyfins ceafe to return. Nor is there any reafon to fear, that this medicine will hinder the maturation of the puftules on the contrary, as this new effervefcence of the blood, and commotion of the humours, may eafily prove an obftacle to the fuppuration; by checking thefe, all things proceed in their ufual course. But firft; the body is to be opened by a clyfter. Now,

the