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Erysipelas.The disease is ordinarily preceded by a severe chill and high fever; u the face be the part affected, there may occur also vomiting, delirum or even stupor. The symptoms become more severe when the inflamation appears in the skin. The appearance of the skin varies somewhat according to the part affected ; but there is ai'W2vs this characteristic feature, that the inflamed skin is sharply marked off from the healthy skin by the difference in color. The outer layer 0/ ':he skin is often raised in the shape of small blisters, whose contents vuzy be watery or may contain matter. After a time these blisters dry into black scabs. When the inflammation subsides, the skin loses its red color, but remains swollen for a considerable time ; the hairs of the affected part fall out, but grow again subsequently. Sometimes a series of boils and abscesses follow in the wake of erysipelas, and at times a considerable' part of the skin mortifies and is removed by suppuration. Erysipelas occurs either as scattered cases which apparently have no connection with one another, or in epidemics. In the latter form it is especially apt to attack patients who are suffering from wounds, injuries or surgical operations. Until the introduction of certain recent improvement in methods of surgical dressing, erysipelas was the scourge of hospitals. It often happened that the disease would sweep an entire ward of surgical patients, attacking every one that had been operated upon ; many cases which would have recovered easily from the effects of the operation died of the erysipelas. Aside from the occurrence of this disease in the wards of hospitals, it is frequently met with in private practice among those who have not been exposed to contagion. These are the so-called sporadic or scattered cases. In these cases erysipelas occurs most frequently in the face ; it has been ascertained that twenty cases of facial erysipelas occur to one case of the disease in other parts of the body. It is especially apt to begin on the side of the nose ; often commencing as it seems in some scratch on the mucous membrane of the nostril, or in a sore of the nostril or lip. The skin just under the eye, extending to the side of the nose, becomes somewhat painful and itchy ; in a few hours the redness appears accompanied by the symptoms of constitutional disturbance - chill, fever, vomiting, etc. - detailed above. The redness and swelling extend over a considerable part of the face, often causing great deformity for the time being. One or both eyes will be closed entirely by the enormous swelling of the lids; the nose, too, is very much thickened, and the nostril is thereby so much diminished in caliber that the patient is often compelled to breath entirely through the mouth. In many cases the inflammation extends upward over the scalp, and may cause great danger to life by attacking the membranes of the brain. Much or all of the hair may be lost in this disease, but the baldness is only temporary. The symptoms of inflammation begin to subside on the fourth or fifth day, and in a few days more the skin usually resumes its natural condition, except that the outer skin peels off in large flakes. Sometimes an affection of the eyes remains for a considerable period after the inflammation of the skin has subsided. This is the usual and favorable termination of facial erysipelas. But it sometimes happens in erysipelas of the face, and frequently when the disease affects other parts of the skin, that the inflammation does not subside so quietly. The redness and pain may diminish considerably, but the swelling remains ; and it will be found that the skin has a peculiar soft, doughy feel; if the finger be pressed firmly on the part a depression remains for a number of minutes after its removal. These symptoms generally indicate that matter has formed in the skin ; in this case recovery will not take place until the skin be opened and the matter permitted to escape. This is absolutely necessary, since otherwise the pus will burrow under the skin, and even downward between the muscles, resulting in a condition which may seriously impair the usefulness of a limb, or even cost the patient his life. Even when promptly opened, the abscess (collection of matter) may run a long and tedious course, and cause mortification of the skin and of the muscles underneath ; sometimes in spite of all treatment, it ultimately exhausts the strength of the patient, and causes a fatal result. Erysipelas of the face often occurs several times in the same individual ; in fact, there are those who suffer from it almost every year during the spring months. In general, erysipelas is more prevalent during the spring and fall than at any other times of the year. Treatment.-The treatment must always be adapted to the patient; and the constitutional treatment is, therefore, of far more consequence than the application of remedies to the inflamed skin. If the individual be at the beginning of the attack somewhat debilitated, or if he be evidently much exhausted by the onset of the disease, it is extremely important that his strength should be sustained in every possible way. For this purpose we rely upon iron and quinine. The following prescription may be given: Tincture of the chloride of iron, - One ounce. Sulphate of quinine, - One drachm. Tincture of nux vomica, - - Half an ounce. Syrup of orange peel, - Two ounces. Water, ------ To make four ounces. Mix, and take a teaspoonful in water every four hours. Sometimes the pain is so intense that it becomes necessary to administer opium. Twenty drops of laudanum may be given every three or four hours until the pain is somewhat allayed. For application to the skin itself one of the best remedies is the following : Tincture of opium, - One ounce. Liquor plumbi sub acetatis (lead water), - Five ounces. Mix and apply by saturating soft cloths with the lotion and laying them upon the inflamed skin. Various measures have been tried to prevent the spread of the disease, for one of the unpleasant features of erysipelas is that the inflammation shows an inclination to extend indefinitely over the skin. In order to limit the inflammation, it was formerly the habit to draw a line around the advancing disease with a stick of lunar caustic. Although success was claimed for this practice, yet it was finally abandoned. In more recent times, several other measures have been proposed and used to accomplish the same result ; among these is the injection of a three per cent, solution of carbolic acid at several points in the skin in front of the advancing inflammation ; this is done by means of a hypodermic syringe, and the process must be repeated two or three times within a couple of days, if the inflammation be not arrested. This measure should be carried into execution only by a physician, and it must be admitted that its utility in limiting the spread of the disease is very doubtful. In the early stage of the inflammation, the application of cloths wrung out in ice water, or of the ice itself, will often be grateful to the patient, though it has probably no influence in arresting the disease ; after the first day or two, cloths wrung out in hot water will usually be found more agreeable to the patient than the ice. 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