VelErpes,(from Herpes 4170 to spread or creep, from their quickly spreading). Tetter. Dr. Cullen places this disease in the class locales, and order dialyses; and defines it, phlyctenae, or a great number of small ulcers crowding together, creeping and difficult to heal.

These ulcers in the skin are sometimes divided into five species. The simple, which consists of single sharp-pointed pustules of a yellowish white colour, inflamed about their bases, and naturally dry. They burn, itch, and smart a day or two, and then disappear.

The tetter, ring worm, or serpigo; darta; are the same in appearance, except that they accumulate in little masses; they are more permanent, for they contain more corrosive matter; they smart and itch more violently, penetrate the skin, and spread considerably, without forming matter, or coming to digestion. The cure is frequently difficult; and they sometimes return at certain seasons. If the disease is constitutional, slight mercurials are necessary; and a solution of hydrargyrus muriatus in lime water, in the proportion of sixteen grains to a pint, may be used as a lotion, or the white calx of mercury, combined with common ointment, may be rubbed on the part. About two scruples may be added to an ounce. When serpigo is constitutional or scorbutic, the great water dock root may be employed, either with or without the mercury, in the form of a diaetetic decoction.

Shingles, or zona aurea, herpes zoster, synonymous in Dr. Cullen's system with his erysipelas phlyctaenodes, as sometimes accompanied with inflammation and fever. It appears in large clusters, on the neck, breast, loins, hips, or thighs: the heads are white and watery, and succeeded by a small round scab resembling a millet seed, and called from thence herpes miliaria. In general the treatment is the same as in erysipelas: the chief indica-tion is to take off the irritability of the system; and for this purpose the cortex Peruvianas and camphor are the best remedies. The prognostic of death from its surrounding the body is false; the malignity of the disease alone affording the only ground of fear. There is a chronic kind peculiar to old people, troublesome from the itching it excites, and sometimes dangerous. The bark internally, and externally, the lime water, occa-sionally with a small proportion of the muriated mer-cury, often succeed.

These two kinds were called by the ancients vermis repens; vermis mordicans; formica miliaris. Wiseman them ambulativa.

Herpes depascens, noma, noli me tangere, ulcus de-pascens, esthiomenus,formix; and by Celsus ignis sacer, because, like the ulcerated erysipelas, it penetrates to the flesh, raising the skin, chiefly on the scalp, into scales of different thicknesses, and leaving a hard swelling on the part. Dr. Cullen thinks it an erythematous inflammation. It resembles an ulcerous erysipelas of a most corrosive kind. The hydrargyrus muriatus, as directed in the lues venerea, with a decoction of the woods, or sarsa, is useful in this complaint; and the sores may be washed with a solution of hydrargyrus muriatus in aq. calcis.

A dose of jalap every fourth day, with an electuary containing two parts of the bark to one of sassafras, has been successful. The mineral acids are sometimes very advantageous; and in this species the tincture of cantharides, recommended by Dr. Mead, we have found useful.

Mr. Bell, in his Treatise on Ulcers, places the tinea and the herpes, as varieties of that species of ulcer, which he denominates cutaneous; adding that the cutaneous ulcer, in all its varieties, may be included in the herpes farinosus, or dry tetter; herpes pustulosus, including the crusta lactea; the tinea capitis (see Achor); herpes miliaris; formica miliaris, cenchrius, of which the ring worm is a variety; and the herpes exedens, including the ulcers called depascent and phagedenic.

The herpes farinosus is the most simple kind. It appears on any part of the body, most frequently on the face, neck, arms, or wrists; comes out in broad spots, consisting of very small red pimples, attended with a troublesome itching, which soon fall oft" in the form of a white powder resembling fine bran: they leave the skin perfectly sound, but the pustules return in the form of a red efflorescence, fall off, and are covered with bran as before.

The herpes pustulosus occurs most frequently in children, generally in the face, and behind the ears; often on other parts of the head, but rarely, on the body. It appears in the form of pustules, which are originally separate and distinct, but afterwards run together. At first they seem to contain nothing but a thin watery serum, which afterwards turns yellow, and, exuding over the whole surface of the part affected, at last dries into a thick crust or scab: when this falls off, the skin below frequently appears entire, with only a slight degree of redness on its surface; but when the matter is more acrid, on the scab falling off, the skin is found slightly excoriated. See Achores.

The herpes miliaris generally appears in clusters, though sometimes in distinct circles of very minute pimples. These are at first perfectly separate, and contain only a clear lymph, which, in the course of the disease, is excreted upon the surface, and forms small distinct scales, that tall off, and leave a considerable inflammation. From hence fresh matter exudes, with the same consequences. The itching in this ulcer is always troublesome,and the matter discharged so tough and viscid, that whatever is applied to the part adheres so as to be removed with difficulty. The whole body-is subject to this disorder, but it most frequently appears on the breast, perinaesum, scrotum, and loins.

The herpes exedens discovers itself on any part of the body, but mostly about the loins, where it sometimes spreads to such a degree as to encircle the waist. At first several small ulcerations appear collected into larger spots of different sizes and various figures, with always more or less of an erysipelatous inflammation. These ulcerations discharge a thin, sharp, serous matter, which sometimes forms into small crusts, that soon fall off; but the discharge is often so thin and acrid, as to spread, and produce similar sores around. Though these excoriations, or ulcers, do not in general proceed further than the true skin, yet the cellular membrane, and, on some occasions, the muscles themselves, are destroyed.

Dr. George Fordyce describes a variety of this disease under the (name of herpes rapiens; and adds that it arises upon the head in small ulcers, covered with a brown, moist, shining crust, similar to venereal ulcers. It is cured, he observes, by the same methods which remove venereal ulcers.

In these cuticular diseases the fluids have been supposed vitiated, and repellents generally unsafe. This is certainly in a great measure true; and in young persons, as well as in robust habits, topical remedies must be employed with caution. In such cases the neutral salts are generally useful; and mercurials, antimonials, or both combined, are necessary at night, assisted in their operation on the skin by opium. In the more debilitated habits, bark with the warmer diaphoretics, particularly the mezereon, are proper, with the mineral acids, and a more generous diet. In all cases, bathing in the warm bath, and the utmost cleanliness in every respect, will be salutary.

In the weak habits, and in old persons, external remedies are most effectual. Simple lime water will be often useful; and about ten grains of hydrargyrus muriatus to a pint of distilled water, with a small proportion of muriated ammonia, is often a beneficial external remedy. In all cases, saturnine applications are either useless or injurious. Mercury must be sometimes continued with the warmer diaphoretic alteratives for a long time; and this has given credit to Spilsbury's drops, which are only a solution of muriated mercury. When the disease recurs, which is not uncommon, a milk and vegetable diet, with issues, and frequent doses of neutral salts, are the best prophylactics. If the disease has produced a deep foul ulcer, the preparations of zinc are the most useful applications.

See Tulpius, lib. iii. Marc. Aurel. Severinus, lib. iv. de Abscessibus, cap. 9. Turner's Diseases of the Skin. Bell on Ulcers, article Cutaneous Ulcer, edit. iii. p. 345. White's Surgery, p. 26.

Herpes. See Purpura scorbutica.

Herpes facie'i. In some constitutions, especially in females, the face is particularly liable to a species of herpes, peculiarly distressing to practitioners. Mercurials, with decoctions of sarsa and miezereon, sometimes succeed; occasionally the Dover's powder, with a small proportion of muriated mercury. Frequently all fail; but the following composition has sometimes been effectual. Herpes 4171 Sulphuris praecipitati 3 ij. cerussae acetatae 3 i. aq. rosarum viij. m. nocte maneq. uten-dum, phiala phiala agitata. See Bell on Ulcers, p. 373.

Herpes ferus. See Erysipelas.

Herpes serpigo. The ring worm; a cutaneous affection common in India, in which the eruption is circular, with a cavity in the middle, apparently surrounded by a ring. The remedy is the cassunda vinegar. An ounce of the fresh bark, roots, tops, or flowers, of the cassunda (cassia sophera Lin. Sp. Pl. 542) are boiled in a pint of vinegar to eight ounces, and a drachm or two applied two or three times a day, previously cleaning the part with soap and water. When this does not succeed, a mild mercurial course, interposing purgatives, with a milk and vegetable diet, has removed the disease.