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CHAP. XII. Of an Erysipelas, or Inflammation.
HAving declared the cure of a Phlegmon, caused by laudable bloud; we must now treat of those Tumors which acknowledg Choler the material cause of their generation, by reason of that affinity which intercedes between Choler and Bloud.* 1.1 Therefore the Tumors caused by natural Choler, are called Erysipelata, or Inflammations; these contain a great heat in them, which chiefly possesses the skin, as also oftentimes some portion of the flesh lying under it. For they are made by most thin and subtle bloud (which upon any occasion of inflammation easi∣ly becomes Cholerick) or by bloud and choler, hotter than is requisite, and sometimes of choler mixed with an acrid serous humor.
That which is made by sincere and pure choler, is called by Galen, a true and perfect Erysipelas.* 1.2 But there arise three differences of Erysipelas, by the admixture of choler with the three other kinds of humors. For if it being predominant be mixed with bloud, it shall be termed Erysipelas Phlegmonades; if with Phlegm, Erysipelas oedematodes; if with Melancholy, Erysipelas Scirrhodes. So that the former and substantive-word shews the humor bearing dominion, but the latter or adje∣ctive that which is inferior in mixture. But if they concurr in equal quantity, there will be there∣upon made Erysipelas Phlegmone, Erysipelas oedema, Erysipelas scirrhus.
Galen acknowledges two kinds of Erysipelas, one simple and without an ulcer,* 1.3 the other ulcera∣ted. For choler drawn and severed from the warmness of the bloud, running by its subtilty and acrimony unto the skin, ulcerates it; but restrained by the gentle heat of the bloud, as a bridle, it is hindered from piercing to the top of the skin, and makes a tumor without an ulcer. But of unna∣tural choler are caused many other kinds of cholerick tumors, as the Herpes, exedens and miliaris; and lastly, all sorts of tumors which come between the Herpes and Cancer. You may know Erysi∣pelas chiefly by three signs, as by their colour, which is a yellowish red; by their quick sliding back into the body at the least compression of the skin, the cause of which is the subtlety of the humor and the outward site of it under the skin, (whereupon, by some Erysipelas is called a disease of the skin;) lastly, by the number of the Symptoms, as heat, pulsation, pain. The heat of an Erysipelas is far greater than that of a Phlegmon, but the pulsation is much less; for as the heat of the bloud is not so great, as that of choler, so it far exceeds choler in quantity and thick∣ness; which may cause compression and obstruction of the adjacent muscle.* 1.4
For Choler easily dissipable by reason of its subtlety quickly vanishes, neither doth it suffer it self to be long contained in the empty spaces between the muscles;* 1.5 neither doth an Erysipelas a∣gree with a Phlegmon in the propriety of the pain. For that of an Erysipelas is pricking and biting without tension, or heaviness; yet the primitive, antecedent, and conjunct causes are alike of both the tumors. Although an Erysipelas may be incident to all parts, yet principally it assails, the face, by reason of the rarity of the skin of that place, and the lightness of the cholerick humor flying upwards. It is ill, when an Erysipelas comes upon a wound, or ulcer, and although it may come to suppuration, yet it is not good; for it shews that there is obstruction by the admixture of a gross humor, whence there is some danger of erosion in the parts next under the skin.
It is good, when Erysipelas comes from within outwards; but ill when from without it retires in∣ward. But if an Erysipelas possess the womb it is deadly, and in like manner if it spread too far over the face, by reason of the sympathy of the membranes of the Brain.