ERYSIPELAS, OR ST. ANTHONY'S FIRE. 183

a point on which different sentiments prevail In the milder formsof the disease venesections are pretty generally dispensed with.Nor is it necessary to repeat bleeding, in any case of erysipelas,so frequently as is done iii other inflammatory disorders. As re-gards this, however, we must be guided by the state of the pulse,and other symptoms, never forgetting the patient's age, strength,tfcc. Cœteris paribus, the patient will bear bleeding better in thecountry than in a large city, and especially in an hospital ; and, ashas been truly remarked, unless there be considerable tendency todelirium and coma, blood-letting can seldom be advantageously re-peated. Instead of this practice, Dr. Bateman judiciously rec-ommends local bleeding and blistering, but not upon or very nearthe diseased surface, whereby he avoids producing the troublesomesores, the frequency of which in former times, after taking bloodfrom erysipelatous parts, led Mr. B. Bell to pronounce a generalcondemnation of the method."

In this disease much mischief is often done by medicine, espe-cially by external applications. People, when they see an inflam-mation, immediately think (hat something ought to be applied to it.This, indeed, is necessary in large phlegmons, or boils; but in anerysipelas the safer course is to apply nothing. Almost all oint-ments, salves, and plasters, being of a greasy nature, tend ratherto obstruct and repel, than promote any discharge from the part.At the beginning of this disease, it is neither safe to promote asuppuration, nor to repel the matter too quickly. The erysipelas,m many respects, resembles the gout, and is to be treated with thegreatest caution. Fine wool, or very soft flannel, are the safestapplications to the part. These not only defend it from the exter-nal air, but likewise promote the perspiration, which has a greattendency to carry off the disease. In Scotland the common peo-ple generally apply a mealy cloth to the parts affected, which isfar from being improper.

It is common to bleed in the erysipelas ; but this likewise re-quires caution. If, however, the fever be high, the pulse hard andstrong, and the patient vigorous, it will be proper to bleed ; but thequantity must be regulated by these circumstances, and the op-eration repeated as the symptoms may require. If the patient hasbeen accustomed 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 seJdom fails to re-lieve the patient. When bathing proves ineffectual, poultices, orsharp sinapisms, may be applied to the soles of the feet, for thesame purpose.

In cases where bleeding is requisite, it is likewise necessary tokeep the body open. This may 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,one of the best medicines when the fever and inflammation runhigh. Haifa drachm of it, with four or five grains of rhubarb,may be taken in the patient"s ordinary drink, three or four times