the throat about the height, or eighth
day of the eruption; or to the violence of the secondary fever. For, first,
as the natural disease is generally taken by particles of the dust of the
contagious matter dried and floating in the air, these are liable to be
arrested by the mucus about the throat and tonsils in their passage to the
lungs, or to the stomach, when they are previously mixed with saliva in the
mouth. Hence the throat inflames like the arm in inoculated patients; and
this increasing, as the disease advances, destroys the patient about the
height.

Secondly, all those upon the face and head come out about the same time,
namely, about one day before those on the hands, and two before those in
the trunk; and thence, when the head is very full, a danger arises from the
secondary fever, which is a purulent, not a variolous fever; for as the
matter from all these of the face and head is reabsorbed at the same time,
the patient is destroyed by the violence of this purulent fever; which in
the distinct small-pox can only be abated by venesection and cathartics;
but in the confluent small-pox requires cordials and opiates, as it is
attended with arterial debility. See Sect. XXXV. 1. and XXXIII. 2. 10.

When the pustules on the face recede, the face swells; and when those of
the hands recede, the hands swell; and the same of the feet in succession.
These swellings seem to be owing to the absorption of variolous matter,
which by its stimulus excites the cutaneous vessels to secrete more lymph,
or serum, or mucus, exactly as happens by the stimulus of a blister. Now,
as a blister sometimes produces strangury many hours after it has risen; it
is plain, that a part of the cantharides is absorbed, and carried to the
neck of the bladder; whether it enters the circulation, or is carried
thither by retrograde movements of the urinary branch of lymphatics; and by
parity of reasoning the variolous matter is absorbed, and swells the face
and hands by its stimulus.

_Variola confluens._ The confluent small-pox consists of numerous pustules,
which appear on the third day of the fever, flow together, are irregularly
circumscribed, flaccid, and little elevated; the fever continuing after the
eruption is complete; convulsions do not precede this kind of small-pox,
and are so far to be esteemed a favourable symptom.

The confluent small-pox is attended with sensitive inirritated fever, or
inflammation with arterial debility; whenc