ERUPTIVE FEVERS. 180 



an affection of the brain. As the pyrexia continues, and often 

 increases with the inflammation of the face ; so the evacuations 

 mentioned may be employed at any time in the course of the 

 disease. 



" This is the fundamental doctrine with regard to the prac- 

 tice. Bleeding is the remedy to be employed, so long as the 

 intensity and spreading of the inflammation or the attendant 

 fever require it, without regard to the time of the disease. The 

 Erysipelas spreading is of little consequence, when there is no 

 fever, or when the fever abates, and particularly when the red- 

 ness does not continue on the parts formerly occupied. 



" I have heard of late, with regard to this subject, of dif- 

 ferent opinions of some very excellent physicians, some Lon- 

 don practitioners, who tell us that the Erysipelas faciei is to be 

 cured by the bark : I cannot pretend to judge till I see the 

 particular cases, and I can imagine that there are cases which are 

 not phlegmonic erysipelas, but on the contrary arise from the ef- 

 fusion of an acrid humour which is remarkably disposed to turn 

 into gangrene : but in this country I have not met with one 

 case of this kind, and of fifty cases, I have seen forty cured by 

 bleeding as plainly as any phlegmasia whatever. I have had 

 cases which proved fatal, but these were few, and evidently with 

 a communication to the internal carotid arteries ; and perhaps 

 they were only to be overcome by this same venesection." 



DCCX. In this, as in other diseases of the head, it is pro- 

 per to put the patient, as often as he can easily bear it, into 

 somewhat of an erect posture. 



DC CXI. As in this disease there is always an external af- 

 fection, and as in many instances there is no other ; so various 

 external applications to the part affected have been proposed ; 

 but almost all of them are of a doubtful effect. The narcotic, 

 refrigerant, and astringent applications are suspected of dispos- 

 ing to gangrene ; spiritous applications seem to increase the 

 inflammation, and all oily or watery applications seem to oc- 

 casion its spreading. The application that seems most safe, 

 and which is now most commonly employed, is that of a dry 

 mealy powder frequently sprinkled upon the inflamed parts. 



" Powdered chalk tolerably answers the purpose of absorp- 

 tion, where there is no considerable exudation ; but where the 



