Treatment .—In eases where the disease arises from puerperal infection treatment has been found of little value. Alcoholic stimulation and the ad ministration of ammonia and bark may be useful in supporting the strength, but local treatment of every kind appears to be useless. It would be advisable in these cases to make trial of benzoate of soda—a salt which has been highly praised by Dr. Lehnebach for its value in puer peral fever in the adult. Two or three grains might be given to a child of a week old every four hours, and if the fever were very high, one or two grains of quinine might be added once in the clay to a close of the benzoate.
In cases where no puerperal infection is suspected, the child should be made to take the tincture of perchloride of iron in frequent doses. For an infant of three months old five drops of the remedy may be given in gly cerine every four hours. At the same time the strength should be sup ported by a careful diet. If the child be at the breast, the mother's milk is no doubt the best food he can take. In addition, he may have a tea spoonful of the brandy-and-egg mixture two or three times a day if his fontanelle is greatly depressed. As long, however, as the strength contin ues good there is no necessity for stimulation. If the patient be hand-fed, care should be taken that his milk is diluted with barley-water or thickened with gelatine ; and the stools must be inspected to see that undigested curd is not passing away from the bowels. If this be so, the milk should be diluted with half its bulk of barley-water or aq. calcis ; and should be aromatised by the addition of two teaspoonsful of an aromatic water to the bottle. Mellin's food, white wine whey, etc., may also be given.
With regard to local treatment, innumerable applications have been recommended. Most of these are sedative or antiseptic. Thus, the in flamed part may be anointed with an ointment composed of equal parts of extract of belladonna and glycerine, and covered with cotton wool. The
application of oil of turpentine has been recommended by Hastreiter. Cavazzani speaks highly of brushing the surface with a lotion composed of one part each of camphor and tannin to eight parts of ether. Painting with tincture of iodine is advocated by some, and with a solution of car bolic acid by others. Heppel states that the spread of the inflammation may be limited by painting the skin at the circumference of the patch, and for a finger's breadth on each side of it, with a ten per cent. solution of carbolic acid. The brush should be used until a distinct staining of the integument has been produced. The plan recommended by Rueter, of in jecting subcutaneously around the margin of the patch a three per cent. solution of carbolic acid, is inadmissible in the case of a young child, in whom symptoms of carbolic acid poisoning would be easily produced. En deavors to limit the spread of the erysipelas, by a line drawn on the skin with nitrate of silver just beyond the margin of the inflamed patch, have been found to be useless. In the child such a proceeding is to be strongly dep recated, as its employment has been sometimes known to lead to the for mation of troublesome sores upon the surface.
An important element in the treatment appears to be covering the in flamed surface from the air. Recently, Mr. Barwell, reviving an old method, has found the utmost benefit to result from covering the affected area with a thick coating of common white lead house-paint, renewing the application as often as any crack appears on the surface of the paint. This plan of treatment seems not only to relieve the pain quickly, but also to reduce the temperature and favourably influence the general symptoms.