In mild cases of erysipelas, attention to the state of the bowels, and
regulation of diet, will often be sufficient to remove the disease.
When there is much disorder of the digestive organs, and particularly
of the biliary secretions, emetics may be given at the commencement;
these are productive of but little good in the more advanced stage, and
their place is advantageously supplied by nauseating doses of antimony,
combined or not with purgatives. One-eighth of a grain of tartarised
antimony may be given in solution every hour, with or without a
due quantity of the tart. potassæ and sodæ, or Rochelle salt. The
hydrargyrum cum creta is often given with great benefit when the tongue
is dry and covered with a brown crust: it may be combined sometimes
advantageously with the compound powder of ipecacuanha. With the same
view calomel with antimonial powder may be exhibited. The exhibition
of saline purges is attended with great good in some severe cases.
Such medicines tend to subdue any arterial excitement that may exist,
evacuate the bowels, promote perspiration, remove the superabundant
bilious matter, and serve to restore the healthy functions of the
liver. In severe cases, more especially of phlegmonous erysipelas,
in which there is acceleration of the pulse, and a degree of febrile
excitement, general bleeding may be had recourse to; but it must be
employed with caution, for the symptoms of increased vascular action
may arise from constitutional irritation, and not be meliorated by the
depletion. The practice is superseded by the timeous and free local
bleeding from incisions, as will be noticed by and by. The exhibition
of the extract of aconite in this and other inflammatory affections, is
often followed by great abatement of vascular excitement, so that the
necessity for abstraction of blood is done away with. The medicine may
be given in doses of half a grain in substance, or dissolved in pure
water, and repeated every third or fourth hour. The sensible effect is
relaxation of the surface, and frequently profuse perspiration; the
arterial pulsations are diminished in frequency and force. The extract
of belladonna, in doses of one-sixteenth of a grain, may then be
substituted with great advantage, and often with the most extraordinary
effect upon the disease. In very many cases, the strength is from the
first to be supported by all possible means, by nourishing diet, by the
exhibition of wine, quinine, and other tonics; more particularly in old
people—in constitutions debilitated by disease—in unhealthy situations,
and when the fever is of a typhoid kind. Bleeding by leeches is not
admissible, for the leech-bites prove a source of irritation, and are
liable to suppurate; erysipelas has often been produced by leeching.
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