Nt

104

OF THE ERYSIPELAS, &c.

ought to be applied to it. This indeed is necessary in large phleg-mons ; but in an erysipelas the safer course is to apply nothing.Almost all ointments, salves, and plaisters, being of a greasy nature,tend rather to obstruct and repel, than promote any discharge fromthe part. At the beginning of this disease it is neither safe to pro-mote a suppuration, nor to repel the matter too quickly. Theerysipelas in many respects resembles the gout, and is to be treatedwith the greatest caution. Fine wool, or very soft flannel, are theafest applications to the part. These not only defend it from theexternal air, but likewise promote the perspiration, which has agreat tendency to carry off the disease. In Scotland the commonpeople generally apply a mealy cloth to the parts affected, whichis far from being improper.

It is common to bleed in the erysipelas; but this likewise requirescaution. If however the fever be high, the pulse hard and strong,and the patient vigorous, it will be prope* to bleed; but the quan-tity must be regulated by these circumstances, and tne operationrepeated as the symptoms may require. If the patient has beenaccustomed to strong liquors, and the disease attacks his head,bleeding is absolutely necessary.

Bathing the feet and legs frequently in lukewarm water, whenthe disease attacks the face or brain, has an excellent effect. Ittends to make a derivation from the head, and seldom fails to relievethe patient. When bathing proves ineffectual, poultices, or sharpsinapisms, may be applied to the soles of the feet, for the samepurpose.

In cases where bleeding is requisite, it is likewise necessary tokeep the body open. This ma) be effected by emollient clysters,or small doses of nitre and rhubarb. Some indeed, recommendvery large doses of nitre in the erysipelas ; but nitre seldom sitseasy on the stomach when taken in large doses. It is, however, oneof the best medicines when the fever and inflammation run high.Half a drachm of it, with four or five grains of rhubarb, may betaken in the patient's ordinary drink four times a-day.

When the erysipelas leaves the extremities, and seizes the headso as to occasion a delirium or stupor, it is absolutely necessary toopen the body. If clysters and mild purgatives fail to have thiseffect, stronger ones must be given. Blistering plaisters mustlikewise be applied to the neck, or behind the ears, and sharpcataplasms laid to the soles of the feet.

When the inflammation cannot be discussed, and the part has atendency to ulcerate, it will then be proper to promote suppura-tion, which may be done by the application of ripening poultices,with saffron, warm fomentations, ajd such like.

When the black, livid, or blue colour of the part shews a ten-dency to mortification, the Peruvian bark must be administered.It may be taken along with acids, as recommended in the small-pox, or in any other form more agreeable to the patient. It mustnot, however, be trifled with, as the patient's life is at stake. Adrachm may be given every two hours, if the symptoms be