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snake-root, the contrayerva-root, faffron, asa foetida, myrrh, and the like. But above all, blisters muft be laid on all the limbs. Such is the neceflity 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 spit, have a looseness almost through the whole disease. Both these evacuations are of great importance; and therefore, as the looseness is not to be inconsiderately stopped in children ; fo in adults, if the spitting does not go on to our wishes, it ought to be promoted by medicines, which stimulate the glands of the mouth; especially gargles made of a decoction of mustard-feed and pepper, with the addition of oxymel. For in the confluent and malig. nant finall-pox, if this flux does not arise, and even continue to the end of the disease, it is a very bad sign.

Sometimes a suppression of urine makes the patient fuffer great pain, receiving little or no relief from diuretics. In this cafe Dr Sydenham directed, that he should be taken out of bed, and exposed to the cool air : which generally has a good effect, But the most convenient method will be to open the body by a clyfter, especially if, the pustules 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 useful, as it is both laxative and diuretic.

Whenever a woman with child is seized with the small-pox, the physician may justly dread the confequences. For he has realon to fear a miscarriage,

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which exposes his patient to two forts of danger, the one from the new fever, which attends that accident; the other from the loss of blood, which may bring her very low. And therefore the farther the is advanced in her pregnancy, the greater risk The runs, because the delivery of a large child cauks a greater flooding than that of a finall one. however affert froin my own knowledge, that a certain woman was delivered of a fon at the full time, while she was actually labouring under this disease; and yet both the mother and the child did well ; but this is a case equally extraordinary and fortunate. But still a good deal depends on the time of the dis, ease, when the abortion happens : because the weakness occafioned thereby is the more dangerous, the more nearly it coincides with the time of the ripening of the pustules. Wherefore, if the efflux be more than nature usually requires, those medicines are to be given, which I have proposed in the bloody fmallpox.

Now, whereas these cases fall out various ways, and physicians have been divided in opinion concerning some of them; it may not be improper to make some animadversions on them feparately.

When a woman in the small-pox suffers abortion, the child most commonly comes into the world with the distemper on it ; but not always. The reason of this difference will easily be understood, by duly considering what I have already faid concerning infection *, and comparing it with what I shall hereafter say concerning the inoculation of the small-pox t. Whereby it will plainly appear, that the feeds of the

* Chap. i. + Chap. v. VOL. II.



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 sometimes happens, that the small. pox, which the infant has contracted in the womb, breaks forth on the second, 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 seventh month of her pregnancy, feized with fo malignant a fort of the confluent small-pox, that there was no appearance of

any one favourable fymptom. For the neither fpit plentifully; nor did the swelling of the hands or feet come on, upon that of the face fubfiding ; nor, in fine, was she assisted by a fux of urine on the decline of the disease; but, on the contrary, her face was all covered with small pimples, which made little or no matter, In this condition, she 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 she died on the fourteenth day. But in the morning of the fourth day following, the infant was feized with convulsions, the forerunners of the eruption, which appeared the same day, and he died in the evening. In this case it is plain, that some suppuration having been made, as usual, on the eleventh day, the distemper passed from the mother


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

But in case there is no miscarriage, the child will be free from the disease during his whole life ; unless he happens to be born before the pustules were come to maturity. For as something naturally inherent in our constitution renders the body liable to the infection; so, when this debt is once paid to nature, we are secure ever after. But the infant in the womb fometimes catches the distemper, without the mother being affected ; a3 I shall prove by this remarkable instance, which I well remember A certain woman, who had formerly had the small-pox, and was now near her reckoning, attended her husband in the distemper. She went her full time, and was delivered of a dead child. It may be needless to observe, that she did not catch it on this occasion : but the dead body of the infant was a horrid fight, being all over covered with the pustules ; a manifest sign that it died of the disease, before it was brought into the world. Wherefore, upon the whole,. let none entertain the least fufpicion, that the same perfon can possibly have this distemper twice. But the reason why the body is liable to the infection once, and no more, is to me as entirely unknown, as to the most 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 said concerning abortions, it is easy to comprehend what judgment ought to be formed of the monthly evacuations coinciding with

* Vid. Mauriceau, sur la grossesse & l'accouchement des femmes, obf. 576. T 22



the small-pox, a circumstance at which people are
apt to be alarmed. For this evacuation is of the fame
kind with the flooding which follows upon abor-
tion: and whether it happens at the usual time, or
is brought on irregularly by the extraordinary effer-
vescence of the blood ; in both cases, 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 restrained by thofe.
medicines which I have recommended in the bloody
fmall-pox, without neglecting to draw blood, if re-
quisite. But we know by experience, that women-
have sometimes uterine discharges through the whole
course of the disease, without loss of strength, or any
other inconvenience.
. The fame judgment may be formed of hæmorrha-
ges at the note, which frequently occur in the begin-
ning of the distemper; for they are occasioned by the
rarefaction of the blood in the small veffels; and there-
.fore, by diminishing the heat, are generally more fer-
viceable than detrimental, unless they run to excess.

It happens fometimes, though not often, that the variolous fever is accompanied with a single or double tertian intermitting tever; in which case, the Peruvian bark, or, which is more convenient, its extract, is to be given at proper distances of time, till the paroxyfins cease to return, Nor is there any reason 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 easily prove an obstacle to the fuppuration ; by checking these, all things proceed in their usual course. But first; the body is to be opened by a clyster. Now,


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