274 THE TREATMENT OF DISEASES. 



all those hygienic measures such as good feeding, fresh air, and quiet wliicn 

 will be found fully discussed under the head of FEVER. 



In erysipelas lowering treatment is seldom or never admissible. The disease is 

 essentially an exhausting disease, and tonic and supporting treatment is necessary. 

 In some cases stimulants are required from the very first, and the indications for 

 their employment are the same as those given whilst speaking of the treatment of 

 fever generally. The strength may be supported by the administration of bark and 

 ammonia (Pr. 13), or quinine (Pr. 9). 



One of the most useful medicines in the treatment of these cases is the tincture 

 of the perchloride of iron, or tincture of steel, as it is not uiifrequently called. So 

 marked is its action that it has "been regarded by some as a specific for this disease. 

 It is essential for its success that it should be given in large and frequently repeated 

 doses. Ten and fifteen drop doses given three times a day do no good, and to obtain 

 a favourable result it is absolutely necessary that it should be given in doses of forty 

 minims or more every four hours. It may be conveniently taken in about a wine- 

 glassful of water. The beneficial effects of the medicine are sometimes seen after 

 the first or second dose ; the local inflammation ceases to extend ; the inflamed part 

 becomes paler, less tender, and less swollen ; the feeling of exhaustion is diminished ; 

 the pulse becomes less frequent ; the temperature falls, and frequently a sound and 

 refreshing sleep ensues. As soon as these changes are observed the dose of the 

 medicine may be reduced. The iron treatment may be combined with the use of 

 stimulants, if there are indications for their employment. 



Aconite (Pr. 38) is of marked service in erysipelas. Administered quite at the 

 commencement it often cuts short the attack ; and even when in spite of it the disease 

 continues, aconite will reduce the swelling and hardness, lessen the redness, and 

 prevent the inflammation from spreading. 



One of our most eminent authorities on treatment has recommended aconite in 

 the following cases : " In children, after vaccination, perhaps when the spots have 

 nearly healed, an erysipelatous redness occasionally appears, spreading over the arm 

 and a greater part of the trunk, usually ceasing in one part, then successively 

 attacking contiguous parts, and leaving a yellow discolouration and desquamation. 

 The redness is often intense, the tissues being very hard, painful, and shiny, and 

 this inflammation may continue for weeks. It may run down the arm, involve the 

 hand, and implicate the greater part of the chest j or it may appear in the leg, and 

 gradually spread to the foot ; or again, it may spread from the hand up to the arm, 

 and once more down to the hand, and this may be repeated many times. Sometimes 

 the inflammation terminates in small abscesses. In cases like these aconite generally 

 at once arrests the inflammation ; and even when it persists the redness is rendered 

 less intense, and the swelling less hard and painful. The troublesome inflammation 

 often arising after the vaccination of adults ordinarily yields to aconite, especially 

 if supplemented by the local application twice daily of the belladonna ointment." 

 In all these cases the aconite may be given in the form of the aconite mixture 

 (Pr. 38), a tea-spoonful every ten minutes for the first hour, and subsequently 

 hourly. 



Belladonna certainly proves efficacious in many cases of erysipelas. It usually 



