or boil these with wax, and anoint the tu mours therewith; the patient must abstain from all falt and fpiced meats, wine, &c. and let him take for his ordinary drink, pullet broth, or mineral waters; he may alfo

drink of barley-water, or water mixed with lemon-juice, and use moderate exercise.

CHAP. VII.

Of CHILBLAINS.

THIS evil rarely affects children till they are about the fourth year of their age. It is univerfally known: The Grecians call γειμεολον οι γειμεολα, malum or ulcus hybernum, It is called in Latin Perniones, quafi ad finem perna, or an ulcer about the heel. It commonly happens in winter, and is confiderably fwelled, and fomewhat painful, red and hot in the cold; but extremely itching in the heat. These tumours or ulcers remain a long time before they fuppurate, and are difficulty refolved, till by the rarefaction of the blood, they vanish at the approach of fpring. They frequently become ulcerous, through

through the bursting of a transparent vesicle, which appears in them; foon after they corrode and destroy the cutis only, if they be not malignant, or in a fcrophulous patient; in which cafes they extend themselves very far, nay destroy all before them, till at length they render the very bones carious. The extremities of the body are the com mon feat of this evil, as being mostly expofed to cold, fuch particularly as the heels; nor are the fingers of the hands, or extremity of the nofe, exempt from them. They are fomented the longer in the heels through their compreffion by the shoes. These ulcers are very difficulty cured, and almost never till the warm weather begins, if the patient does not conftantly keep his bed.

: CAUSES. Chilblains fpring from the infarction of the lymphatic veffels in the af fected parts, whereby a fpurious phlegmon, not a genuine inflamation, is produced at length; for those tumours have not sufficient heat, pain, or redness to characterize them inflammations. The lymph thus ftagnates through its fpiffitude from any intenfe cold, particularly in infants, all the F 4 humours

humours of whom are naturally vifcid and oleaginous; whilst persons who have a more vigorous circulation, and consequently thiner humours, are not fo fubject to this evil, as we observe in adults and lively children. On the contrary, phlegmatic, cold perfons of all ages are very much disposed to them. From this it appears, that in all parts, where the motion of the lymph is flower and weaker, these tumours will be more frequent, as in the heels, &c. where they are fomented the more, through the conftant neceffity of walking, the compreffion of the fhoes, and the parts being very much exposed to the injuries of the weather.

SYMPTOMS. The fymptoms of Chilblains hardly deserve any detail; but in fhort, the tumour is hot from the ftagnation of the blood in the capillary arteries, through the compreffion made by the lymphatic infarction. The pain, &c. is augmented in the cold, through the constriction and diftraction of the fibres. The itching which happens when near the fire, &c. is owing to the agitation and diftenfion produced by the rarefaction of the congealed lymph. As to the Diagnostics, the disorder and its

various

various degrees are palpable. The Prognoftics are not dangerous upon any account, if a caries does not fupervene; but this is an extraordinary cafe, and rarely happens, except when the patient is fcrophulous, in which cafe the caries should be rather derived from that virulent quality of the humours than from the perniones.

CURE. The treatment of Chilblains is prophylactic or curative; the former is intended to prevent the evil in fuch as are accustomed to it; the latter to remove the diforder after it appears.

A prophylactic cure of Chilblains is very difficult, for they commonly return in the cold weather in fpight of all remedies, till time and age fortify the parts which were weakened by them. Nay, this natural prevention is also very flow: For the parts once affected, are the more difpofed to this dif order the following winter, and they commonly remain tumified; yet, to affist nature, the following precautions are to be obferved:

1. Let the patient guard against fudden cold; and if he thus expofes himself, let him immediately afterwards avoid fudden heat, for by fudden cold the lymph is in

Spiffated,

fpiffated, and by the ensuing heat, so rari*fied, that as the ftagnant lymph is expanded, its receptacles are the more diftended, weakened and infarcted. Wherefore the heat in this cafe fhould be a gradual one,

proper
excited by moderate exercise.

2. Let the parts fubject to this evil, which are most commonly the feet or hands, be bathed every night, or thrice a weak, with a decoction of radishes; for the volatil aftringent parts of this plant, fortify the weakened members.

3. Hot afhes applied betwixt cloaths to the tumified parts, have fuccefsfully reduced several of these tumours, by the aftringent falts they contain.

4. Simple vulnerary liquors, or camphorated brandy, animate the languid circulation, and corroborate the affected part. The patient's stockings may be also moistened with any of these liquors at night, during which time they may be worn. Some recommend the ftraw-berry bufh, or its fruit, to be used in this cafe; but these are useless. :. In order to the curative treatment, a decoction of radishes may be likewife employed, or that of marsh-mallow roots, in which

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