xternal erysipelas on the extremities.

This disease, consisting of an erysipelatous inflammation, may occasion the
great debility sooner to occur than in inflammation of the uterus; which
latter is neither erysipelatous, I suppose, nor contagious. And the success
of Dr. Gordon's practice seems to correspond with that of Dr. Rush in the
contagious fever or plague at Philadelphia; which appeared to be much
assisted by early evacuations. One case I saw some time ago, where violent
unceasing pain of the whole abdomen occurred a few hours after delivery,
with quick pulse; which ceased after the patient had twice lost about eight
ounces of blood, and had taken a moderate cathartic with calomel.

This case induces me to think, that it might be safer and equally
efficacious, to take less blood at first, than Dr. Gordon mentions, and to
repeat the operation in a few hours, if the continuance of the symptoms
should require it. And the same in respect to the cathartic, which might
perhaps be given in less quantity, and repeated every two or three hours.

Nor should I wish to give an opiate after the first venesection and
cathartic; as I suspect that this might be injurious, except those
evacuations had emptied the vessels so much, that the stimulus of the
opiate should act only by increasing the absorption of the new vessels or
fluids produced on the surfaces of the inflamed membranes. In other
inflammations of the bowels, and in acute rheumatism, I have seen the
disease much prolonged, and I believe sometimes rendered fatal, by the too
early administration of opiates, either along with cathartics, or at their
intervals; while a small dose of opium given after sufficient evacuations
produces absorption only by its stimulus, and much contributes to the cure
of the patient. We may have visible testimony of this effect of opium, when
a solution of it is put into an inflamed eye; if it be thus used previous
to sufficient evacuation, it increases the inflammation; if it be used
after sufficient evacuation, it increases absorption only, and clears the
eye in a very small time.

I cannot omit observing, from considering these circumstances, how unwise
is the common practice of giving an opiate to every woman immediately after
her delivery, which must often have been of dangerous consequence.

END OF THE SECOND PART.

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ZOONOMIAE AUCTORI

_S.P.D._

AMICUS.

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