legmonic inflammation seems to be
owing in part to the less distensibility of the cuticle than of the
cellular membrane, and in part to the ready exhalation of the thinner parts
of the secreted fluids through its pores.

This erysipelas is generally preceded by a fever for two or three days
before the eruption, which is liable to appear in some places, as it
declines in others; and seems frequently to arise from a previous scratch
or injury of the skin; and is attended sometimes with inflammation of the
cellular membrane beneath the skin; whence a real phlegmon and collection
of matter becomes joined to the erysipelas, and either occasions or
increases the irritated fever, which attends it.

There is a greater sympathy between the external skin and the meninges of
the brain, than between the cellular membrane and those meninges; whence
erysipelas is more liable to be preceded or attended, or succeeded, by
delirium than internal phlegmons. I except the mumps, or parotitis,
described below; which is properly an external gland, as its excretory duct
opens into the air. When pain of the head or delirium precedes the
cutaneous eruption of the face, there is some reason to believe, that the
primary disease is a torpor of the meninges of the brain; and that the
succeeding violent action is transferred to the skin of the face by
sensitive association; and that a similar sympathy occurs between some
internal membranes and the skin over them, when erysipelas appears on other
parts of the body. If this circumstance should be supported by further
evidence, this disease should be removed into Class IV. along with the
rheumatism and gout. See Class IV. 1. 2. 17.

This supposed retropulsion of erysipelas on the brain from the frequent
appearance of delirium, has prevented the free use of the lancet early in
this disease to the destruction of many; as it has prevented the subduing
of the general inflammation, and thus has in the end produced the
particular one on the brain. Mr. B----, a delicate gentleman about sixty,
had an erysipelas beginning near one ear, and extending by degrees over the
whole head, with hard, full, and strong pulse; blood was taken from him
four or five times in considerable quantity, with gentle cathartics, with
calomel, diluents, and cool air, and he recovered without any signs of
delirium, or inflammation of the meninges of the brain. Mr. W----, a strong
corpulent man of inferior life, had erysipelas over his