188 PRACTICE OF PHYSIC. 



lastly, as the swelling of the eye-lids, in this disease, frequently 

 ends in a suppuration ; so, from these considerations, it seems 

 doubtful if this disease be properly, in Nosology, separated from 

 the Phlegmasise. At any rate, I take the disease I have de- 

 scribed to be what physicians have named the Erysipelas phleg- 

 monodes, and that it partakes a great deal of the nature of the 

 Phlegmasiae. 



" It is a common, but not well-founded principle, that what 

 takes place in the exanthemata is a necessary circumstance to 

 the expulsion of morbific matter, and that we are therefore to 

 be very cautious in employing blood-letting, lest it should weaken 

 the vis insita necessary for the expulsion of that matter. Upon 

 this principle many practitioners have either avoided blood- 

 letting altogether, or were very cautious with regard to it. We 

 have now, I may say, got over that prejudice. With regard 

 to Erysipelas, nothing is more evident, than that it is not an 

 exanthema like the others, because the fever does not cease upon 

 the eruption ; on the contrary, the fever very often supervenes 

 upon the topical affection ; and though it does not, and exists 

 previously, we find that it not only continues to subsist with 

 the topical affection, but increases in the same proportion. I 

 think, therefore, that bleeding is as necessary here as in any 

 phlegmasiae, where we allow the fever to depend upon the topi- 

 cal affection : and further, not only on the first appearance of 

 suspicion, but at any time in the after progress of Erysipelas, 

 bleeding may be practised, and is necessary, in proportion to the 

 degree of the fever attending, and to the violence of the topical 

 inflammation. The practice in this part of the world, in this 

 respect, is so commonly established, that I need not add any 

 thing further." 



DCCVIII. Upon this conclusion, the Erysipelas of the face 

 is to be cured very much in the same manner as phlegmonic in- 

 flammations, by blood-letting, cooling purgatives, and by em- 

 ploying every part of the antiphlogistic regimen ; and our ex- 

 perience has confirmed the fitness of this method of cure. " I 

 have here followed Sydenham very exactly." 



DCCIX. The evacuations of blood-letting and purging, are 

 to be employed more or less according to the urgency of symp- 

 toms, particularly those of the pyrexia, and of those which mark 



