172 ERYSIPELAS. 



the subsidence of the fever as aids to convalescence. At this 

 period tonics, and especially iron, either alone in the form of 

 the tincture or solution of the perchloride, or combined as the 

 sulphate, or the sulphate of iron and quinine with sulphuric 

 acid, or in bolus Avith vegetable tonics, and alternated Avith the 

 stimulant draught already mentioned, is productive of good. 



Of local applications the best is warm water : cold I have 

 tried in various ways and extensively, but with indifferent 

 results. To obtain the full benefit from the warm-water appli- 

 cations, they ought to be employed as soon as the swelhngs 

 commence — not for a few minutes two or three times daily, 

 but for an hour or two continuously ; and when the pain is 

 severe, a little tincture of opium may with advantage be added 

 to the water. 



When exudation has taken place in the subdermal tissues, 

 free scarifications are of much benefit, both in relieving the 

 tension and in permitting the effused serum to drain off: these 

 may probably require to be performed daily, and are best done 

 immediately previous to the fomentation, by which the dis- 

 charge is favoured during the after-application of the warm 

 water. In both these methods of treatment, with or without 

 the employment of scarifications, a certain amount of protec- 

 tion and relief from pain appears to be aftbrded by dusting the 

 limb with Avheaten flour, having previously smeared it with 

 carbolized oil. Whenever it is certain that pus has collected 

 beneath the skin, a free incision ought to be made so as to 

 allow of its escape. 



Patches from Avhich the skin has been removed by slough- 

 ing, unhealthy sores resulting from abrasions or incisions which 

 are discharging foetid sanies, should be kept clean and dressed 

 twice daily, so as to promote healthy action and destroy the 

 foetor, with carbolized oil, a solution of permanganate of potass, 

 or chloride of zinc. The application over the skin, at the 

 union of the healthy Avith the diseased parts, of tincture of 

 iodine or solution of nitrate of silver, Avith a vieAV to arrest the 

 progress of the local inflammation, does not in our patients 

 appear to be productive of much or any effect. Even free 

 scarification and cauterization, carried out on the boundary of 

 the healthy tissue, seem equally impotent for the attainment 

 of a like result. 



