TREATMENT. 273 



dition of the lymphatic vessels and glands ; the swelling, how- 

 ever, is different. In lymphangitis the swelling originates in 

 the superior gland-structures of the limbs, and extends to the 

 absorbents, producing uniform and general infiltration of the 

 connective-tissue. In farcy, the swelling more often originates 

 by the production of papules, around which infiltration takes 

 place, and from which it extends and spreads in different direc- 

 tions. The sores, too, when such exist, differ in position and 

 character. 



Treatment. — The course of treatment all but universally 

 adopted in the management of this disease is the antiphlogistic. 

 Generally regarded as one of those disturbances which are most 

 successfully combated by the early employment of free blood- 

 letting in conjunction with active purgation, the same system 

 has been advocated and carried out in all stages, and under 

 somewhat opposing conditions. Although I have pursued this 

 treatment largely, and observed its action carefully, I am 

 satisfied that it does not in every case yield the results we 

 desire, and that in its general employment much discrimination 

 is needed. In cases where the attack of Ijonphangitis may be 

 associated with, or follow as a sequel of, some debilitating 

 disease, blood-letting is counter-indicated. Local bleeding, 

 either from the greater saphena vein, or the circumflex of the 

 foot, formerly much extolled, does not possess anything to 

 recommend it in preference to the now more commonly adopted 

 practice of taking blood from the jugular ; while, beside other 

 disadvantages, it is open to the objection of inflicting a wound, 

 which, from the diseased action in the limb, is likely to prove 

 troublesome in the further local treatment of the case. 



Of the beneficial results to be obtained from the general 

 employment of mild purgatives in lymphangitis there are 

 fewer doubts, although, like every other curative means, they 

 are capable of being abused ; excessive purgation being here 

 apt to result in enteric complications, or congestion of the 

 lungs or feet. In the early stages of the disease, and where 

 the febrile symptoms are marked and persistent, it will always 

 be advantageous to administer every three or four hours a little 

 of the ordinary saline febrifuge mixture — composed of nitrate, 

 or chlorate of potash, or both, with solution of acetate of 

 ammonia, and sweet spirits of nitre — to which from four to six 



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