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trary, ulcerates briskly, and hence should be allowed to Gen. VI.

Spec. II. burst or at least should not be opened early.

Erythema At the commencement of this inflammation there is erysipelatocommonly some degree of fever, accompanied with pro- Erysipelastration of strength and dejection of spirits, and especi- tous ery

thema. ally with loss of appetite. But the fever soon subsides,

Some dewhile the inflammation pursues its course ; yet since one of source of irritation has thus departed, it is less violent, fever at

first; and sometimes assumes a chronic character.

which soon As this, like the last, is a disease of weakness, the subsides,

while the insame general tonic plan will be calculated to oppose it; fiammation and where there is a tendency in the separated skin to

Treatinent. crack, absorbent earths or powders should be scattered

Tonics. freely over the ulcerative or oozing parts, to imbibe the Absorbent acrid fluid as it escapes, or the ulceration will soon be- earths apcome extensive; and the feeble and inflamed subjacent plied locally. skin, hereby exposed to the stimulus of external agency, will grow gangrenous with great speed. Finely pounded Starch. starch is a useful powder for this purpose; as it combines a tonic and an astringent with an absorbent power ; so, likewise, is a mixture of equal parts of starch and finely levigated calamine or rhubarb. The last I have Calamine. sometimes thought peculiarly effectual in checking the Rhubarb. irritation ; as the second appears to be in preventing the further spread of the inflamed outline that surrounds the separated cuticle. This species of inflammation sometimes attacks infants Sometimes

attacks infrom a very early period after birth; and, what is more fants; singular, they have in a few instances been born with it. In such cases it appears to be produced by some occasional cause, co-operating with an erythematic diathesis derived hereditarily. It generally assumes the mixt chiefly in a

mixt form, form of phlegmonous erythema; suppurates imperfectly as it takes its course through the cellular membrane, and is often succeeded by gangrene. Its progress is very proceeding rapid from the relaxed state of the infantile fibre: and

rapidity, from the extrication of air, as soon as gangrene is pro- and spreadduced, the tumified surface bas the mixt feel already abdominal noticed of fluctuation and crepitation. It commences viscera.

with great



Gen. VI. usually about the genitals, works its way below towards

Spec. II. Erythema

the thighs and legs, and above towards the abdomen, erysipelato- and often excites on the peritonæum the same caseous or Erysipela- purulent secretion which is so apt to form on this memtous ery- brane in puerperal fever. As there is no disposition to

adhesion, the fluid spreads in every direction, wherever Purulent

the ulceration makes a way for it; and hence it has often very copi- descended in great abundance into the tunica vaginalis ous.

and labia pudendi. Treatment. Stimulant epithems of ether, alcohol, and campho

rated spirits, applied in the first stage of the disease to the parts affected, have been found the most beneficial practice : they act as counter-irritants, and take off the morbid excitement by the production of an artificial and more manageable inflammation. To these ought by all means to be added the use of the bark in any way in which it can be introduced, especially in that of injections repeated several times a day.



Gangrenous Erythema.



Ges. VI. THE gangrenous erythema, like the two preceding

species, is a frequent companion of debilitated or relaxed chiefly to be constitutions, but is mostly to be met with in advanced found.

age, or weakly adolescence, or infancy; and particularly


where, in old age, the constitution has been broken down Gen. VI. by habits of intemperance and excess; the circulation is

Erythema languid, and the blood even in the arteries assumes a gangrænovenous appearance. The inflamınatory stage is in these sum.

Gangrecases sometimes very slight, and the gangrene is ushered nous in

flammation. in with very little previous affection.

Anteceded Either of the preceding species will pass readily into by little the present, in a warm, stagnant, and corrupt air; for previous inthe same reason that all hospital wounds run rapidly A result of into the same state under the same circumstances, as we the preshall have to notice hereafter.


species in Local applications are here of far less importance than vitiated air. an attention to the general condition of the constitution. Curative inStimulants and perfect cleanliness are perhaps all that tention. are demanded under the first head; while, under the second, pure air, and a steady course of tonic medicines and diet, adapted to the age and habits of the patient, are absolutely indispensable; and can alone furnish any hope of recovery.

How far this disease appertains to the ignis sacer of the Roman writers, will be seen under the ensuing species, which forms another subdivision of the same affection.



Ursicular Crythema.



This species admits of two varieties, which have been Gen. VI.

Spec. IV. pointed out from the age of Celsus :

culare be

GEN. VI. a Benignum. Benign vesicular Erythema.

B Corrosivum. Erosive vesicular Erythema. Erythema vesiculare. In the First, the redness and vesicles advance without Vesicular erythema.

a breach of the cuticle, as the part that has passed

through the action is healing. a E. vesi

In the second, the vesicles break in the part first afnignum.

fected; and the erosive fluid produces tracks of sanious Benign ve- ulceration as the redness advances. sicular erythema. Under the present and the preceding species is incluB E. vesi- ded the iGNIS SACER of the ancients; about which much culare cor

has been written, but which has been seldom understood, rosivum. Erosive and never hitherto allotted a clear methodic position. vesicular

The author has taken some pains upon the subject, and erythema. General trusts he will be able to establish the true boundary and remarks.

character of a disease, not more frequently described by Ignis sacer

the physicians, than celebrated by the poets of antiquity. synonymous with The common error has consisted in making the ignis this and the

sacer, or holy fire, an exanthem or eruptive fever; an preceding species. erysipelas or a pestis; or some other idiopathic fever of

the same order. There is no doubt, indeed, that, like the

erysipelatous erythema, it has at times been met with as Common

an accompanying symptom in pestis ; and when we shall view of come to treat of this disease, a distinct notice will be ignis sacer; taken of the variety which such an accompaniment pro

duces, and of which the plague of Athens seems to furusually ac nish us with a tolerable example; but the ignis sacer, in with but its genuine and simple state, instead of being marked rexy.

with a low eruptive fever, has often very little fever of any kind; certainly nothing more than symptomatic fever; and by Celsus is described as being best cured by

an ephemeral or any other fever which may give increasA result of ed action to the system; hereby proving that this, like

the entire group of erythemas, is a result of debility. Import of

In ancient times some diseases were supposed to be insacer in medicine.

Alicted on mankind by the special interposition of the Divinity, or of his ministers : and to these was assigned the name of sacer, or holy; though the peculiar crimes for which they were inflicted, or the names of the particular persons who in this manner first drew down the special


little py

vengeance of Heaven upon their atrocities, have not been Gen. VI. communicated to us. The later term of Saint or Sanc- Spec. IV.

Erythema tus, as in St. Anthony's fire or St. Vitus's dance, are of vesiculare.

Vesicular parallel origin, and express corporeal punishments first

erythema. inflicted by the agents or supposed agents of the deity Sanctus

, whose names they respectively bear. Ignis is a term or Saint. expressive of the heat, redness, acrimony, and erosive power of a disease; and is hence applied to the present in common with many other affections.

The best description of the IGNIS SACER that has de- Description scended to us from the Roman writers, is that of Celsus. sus.

from CelHe represents it as a genus comprising two species, the His first first of which is precisely parallel with the species before species, sy

nonymous us, and the second with the erythema gangrænosum, or with erythe preceding; and, in order to prevent any doubt upon cufare.

thema vesithis subject, the definitions of both species are here given, as nearly as may be, in the words of Celsus himself. “ It has”, says he, “ two species; one (the vesicular erythema of the present system) is reddish, or a mixture of redness and paleness, rough with approximating vesicles (pustula), none of which are larger than the rest, and which for the most part are very small. In these are almost always found a fluid (pus), and often a red colour with heat.”* Then follows his description His two vaof the two varieties just given, the benign and erosive, rieties of

this species. in the following words : “sometimes it trails along, the part healing that was first diseased”; corresponding with the variety a of the present system. And “ sometimes the part ulcerating; in consequence of which the vesicles (pustulæ) break, the ulceration keeps spreading, and the fluid escapes”; alike corresponding with the variety B. His second Celsus then passes on to describe his second species, species sywhich answers to the character and almost to the words with eryof erythema gangrænosum, or that we have just consi- thema gandered. “The other species”, says he, “consists in an ulceration of the cuticle, without depth, broad, sublivid, but unequally so; and the middle heals, while the bound


De Medicinna. Lib. v. Cap. XXVIII. Sect. 4.

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