Cases of erysipelas successfully treated, chiefly by venesection / by Andrew Duncan.

  • Duncan Andrew, 1773-1832.
Date:
[1821?]
Catalogue details

Licence: Public Domain Mark

Credit: Cases of erysipelas successfully treated, chiefly by venesection / by Andrew Duncan. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    gether without the suspicion of its being propagated by conta- gion ; and I readily seized the opportunity thus presented, of ascertaining whether the ideas I had formed of the pathology of this disease were more correct than those generally entertained. I am well aware that blood-letting has been, and perhaps is, often employed * in the treatment of erysipelas; but it is not a general practice; and the writers of greatest authority represent it as admissible only in certain cases and forms of the disease, of comparatively rare occurrence. In proof of this, it will be sufficient to quote a few of the most esteemed modern authors. Richter recommends, in the common febrile rose, laxatives and diaphoretics when the disease is slight, and emetics when it is more severe; an^ in the inflammatory rose, erysipelasiMegmo- nodes, he says the antiphlogistic treatment, and even detraction of blood, are here proper. But in no other inflammations must we exercise so much .caution in their employment as in the rose; especially when, at the same time, bilious symptoms are present. Commonly local bleedings are sufficient. Leeches are applied behind the ear, and sometimes it is necessary to re- peat them. According to rule, it is only the rose of the face, ■which attains such a degree as to indicate the detraction of blood, especially when there are symptoms of sympathetic in- flammation of the brain, violent headach, strong pulsation of the carotids, delirium, and coma. In such a case, sometimes even a small general bleeding is necessary; by which means, undoubtedly, the termination in suppuration, which is always dangerous, may be avoided. f Rcil expresses a very similar opinion. If the rose be complicated, especially with general fever, with inflammation of the brain and of the lungs; and if this fever, as well as the rose, have the character of synocha; if the patient be young, plethoric, and robust, we must let blood once and again, and, after the venesection, apply leeches. But blood must be drawn only when it is indicated, and not more than is indicated ; especially as the rose is apt to arise in a con- currence of circumstances which do not bear large evacuations of blood.» % Callisen does not even allude to blood-letting, when he enu- merates the remedies employed in erysipelas. Similar cautions • Mead, Sydenham, Cullen, Burserius, &c. &c. t Die specielle Therapie von D. August. Gottl. Ricliter. Band. Berlinj 1813, p. 225. t J. de Reil Fieberlehre. I' Band. p. 569. Svo. Hall, 1804.