mouth, where it finds lefs refiftance, and the fucceeding cicatrice will be very little; but if it be open'd with the knife, let the orifice be ever fo little, a large and troublefome cicatrice will enfue. Whether it be. open'd by art or nature, the abscess should be expreffed, deterged and confolidated, and. treated like all other ulcers.

CHA P. XII.

Of THRUSHES, or, APH THÆ.

TH

HRUSHES frequently begin by small whitish veficles, called Dipnoides, which terminate in feveral fmall and round ulcers. But the moft genuine Aphtha are a fort of Phlyctania, which, when broken, yield an acrid Sanies. They are commonly feated on the lips, gums or tongue, especially, it's top and fides, and they frequently arrive at the fauces. By confidering the ftructure of the fkin of thefe parts, and the mucous, or, which are the fame, the Sebaceous glands, wherewith thefe parts are furnished; it is evident, that these glands are the feat of this diforder, as well as of the fcurvy; for thefe

glands naturally fecern a vifcid humour, which puts on various colours and confiftences, according to the degree of heat and aduftion of the tongue, which are more manifeft on its top and fides, through the greater number of thofe glands in thofe parts; whence Aphtha are fo common therein in most intermittent fevers. The diforder once begun, spreads infenfibly from one veficle inclos'd on all fides, to another, and so forth. The humour of these glands in it's natural state is very mild, balfamic, and intended to wet and lubricate the mouth, and it's contents. The caufes of Thrushes may be reduced, 1. To the redundance of this humour. 2. To it's acrimony. 3. To the concurrence of both these causes.

1. The redundant humour fwells the glands beyond their proper tone; ftagnates in their cavities, compreffes the adjacent blood veffels, and induces a flight inflammation; whence the bafis of each tumour is furrounded with a red circle.

2. The acrimony of the humour, independent of it's redundance, is capable by e rofion to induce inflammation and fpread the evil. The center of each tumour, is com→

monly

monly depreffed and funk lower than the.. reft of it.

03. The explication of the two preceding caufes makes the third, which is a combination of the two, fufficiently manifeft: obferving that this caufe will be more intense than any of the former. Thus far of the conjunct causes, and the caufes which give rife to thefe, are alfo evident. We shall only enumerate the ufual caufes of the acrimo

ny

of the mucous humour, which is the most frequent occafion of this diforder. This humour then, like all the others of the body, derives it's acrimony from the blood, which is thus infected from the nurfes milk, which becomes acrid by violent paffions of the mind; exceffive exercife; drinking too much wine, or other fpirituous liquors; frequent menftruation; or the infant's indigeftion: or, if the nurfe's milk is fo little, as to oblige the infant to fuck too hard and with violent efforts, all the parts of his mouth are put into fuch an heat, that its humours become acrid, and give rife to Thrushes, which may alfo fpring from a venereal virulence fucked in from the mother.

SYMPTOMS. The child's mouth is inflamed, and confquently hot, red and painful, through the acrimony and irritation of the morbid humours. Hence he fuffers confiderably in fucking; he is reftlefs, fleeps very little, and at last a fever is excited.

DIAGNOSTICS. The existence of the disorder is evident to the touch and infpection, the nurse alone may evince it, for her nipple is commonly affected with the fame evil.

The different caufes are more difficult to be accounted for, but we may impute the diforder in general to the nurfe; for let us fuppofe, that the infant is naturally thus dif pofed, yet if the nurfe's milk be good, it ought to correct this vicious difpofition of the infant. If the evil does not rife from this caufe, it must neceffarily proceed from the nurfe; fo that fhe is blameable in both cafes. As to the diftinction of the ordinary and venereal Thrushes, the former are mild, benign, few in number, and make flow progress: but the venereal Aphthæ are very numerous, contagious, and spread predigious ly, in a fhort time.

PROG

PROGNOSTICS. Thrushes of infants are never dangerous, or very rarely threaten bad consequences, if they are benign; in which cafe they are easily removed by changing the nurse.

CURE. If the infant's mouth be very hot and painful, he may be blooded; and if he be old or strong enough, let him be purged with compound fyrup of fuccory, adding a little of the powder of rhubarb, according to his age and ftrength.

. After purgation, let him take the common remedy, or the abforbent powder of crabbs eyes, prepared hartshorn, diaphoretic mineral, the peruvian bark and the anthelmin thic powder; or, what I have frequently pre→ scribed with great fuccefs in this cafe, the pulv. temperans of Doctor Stabl. Thefe may be exhibited in the child's ordinary drink, or meat, and thefe are the internal remedies used. Now we come to those of the topical kind, which are to be employed in the following manner, beginning with the mildest fort.

I. If the evil be mild, bathe it with a decoction of barley mixed with honey of rofes, or with a decoction of the leaves of plantain,