Erysipelas

[Gr. eruo, I draw, and pelas, near or adjoining.] ( Med.) The name given to a peculiar kind of inflammation of the skin, so called from its tendency to spread to adjoining parts. It is known also as St. Anthony's fire or ignis sacer, and in common language as the Rose. It most commonly attacks the head and face; but it also sometimes occurs on other parts of the body. The local inflammation is preceded and accompanied with fever, and there are usually certain premonitory symptoms that precede the outbreak of the disease; the patient feels ill, - shivery, feeble, languid, and often drowsy. After these symptoms have continued for some time, a red spot appears on some part of the body, accompanied with a burning heat and tingling. When attacking the face, it usually makes its appearance on the bridge of the nose, and rapidly extends itself to the eyelids, cheeks, and forehead. The redne is not intense, but rather of a pale rose-color, and goes away temporarily on pre ure, but returns immediately on its removal, and no pit remains after the pre ure. By the second night, or morning of the third day, after the commencement of the fever, the face begins to swell, the eyes are completely closed, and the form of the features scarcely recognizable. On the fourth or fifth day, vesications appear on the inflamed surface, and break or subside on the fifth or sixth, when the redne changes to a yellowish hue, and the swelling and fever begin to diminish; and on the eighth day they both disappear. The progre of the disease, however, is more rapid and its course of shorter duration in the young and sanguine than in those more advanced in life; the tumefaction in the former being sometimes fully formed on the second day, and the whole terminating on the sixth or seventh, while in the latter it may be protracted to the tenth or twelfth. Suppuration rarely occurs, except occasionally in the eyelids or scalp. Sometimes the inflammation and swelling extend to the neck and throat, and may produce suffocation. In very bad cases, delirium and coma come on, and death ensues from effusion on the brain. No remi ion of the fever takes place on the appearance of the inflammation; but, on the contrary, it generally increases with the progre of the inflammation, and only ceases when it goes away. When the complaint is mild, the inflammation and fever generally cease gradually without any evident crisis. Among frequent causes of this disease, are exposure to a cold and moist atmosphere, sudden changes of temperature, intemperance and unwholesome articles of food. It is sometimes also induced by wounds or sores, or even by a slight puncture or scratch of the skin in persons predisposed to it. It is likewise contagious, and has to be strictly guarded against by means of ventilation and cleanline in hospitals. Though the proper seat of the inflammation is the skin, it frequently extends to the parts underneath. Authors usually distinguish four kinds of this disease, the phlegmonous, ædem a to us, gangrenous, and erratic. The first of these is characterized by the greatest degree of inflammation. In the ædem a to us, the inflammatory symptoms are le intense, but the tumefaction is greater. It most commonly affects persons of debilitated constitutions, dropsical persons, and those who have been long subject to other chronic maladies. It is attended with considerable danger when it affects the face, and often terminates fatally on the seventh or eighth day. The gangrenous form most commonly occurs in the face, neck, or shoulders, and is accompanied with symptoms of low fever and delirium, which is succeeded by coma. The color of the affected parts is of a dark red, and scattered vesicles appear upon the surface, which frequently terminate in gangrenous ulcerations. It is always a tedious and often a fatal form of the disease. In erratic E. the morbid patches appear one after the other in different parts of the body; sometimes thus travelling progre ively from the head to the extremities. It is rarely attended with danger, and usually terminates in a week or ten days. In the treatment of E. , very much depends upon the nature of the disease and the condition of the patient. If the patient be young and sanguine, and the inflammation high, bleeding may be resorted to. When, on the other hand, the system is enfeebled, tonics, a nourishing diet, and even stimulants may be nece ary. in order to strengthen the patient. In general, moderate purgatives, diaphoretics, and strict confinement to bed, are to be adopted. Recent investigation shows that E. is caused by the presence of a living organism, a micrococus in the lymphatic ve els of the skin, it is a parasitic disease, local and hypo dermatic germicidal treatment is recommended, such as a weak solution of corrosive sublimate, bicyanide of mercury, carbolic or salicylic acid. Erysipel'atoid, Erysipel'atous, Erysip'. elous, Resembling erysipelas, partaking of its nature. Erythe'ma, n. [Gr., redne .] ( Med .) A redne of the skin, generally observed in patches, and sometimes attended with puffine of the parts affected. It is a le er kind of erysipelas, not attended with febrile symptoms of any consequence, except in a form described as erythema nodosum, which is characterized by elevated and somewhat indurated nodules of a red color rising on the legs, and sometimes on the arms. These generally are more or le oval in shape. The onset of this form is marked by febrile excitement. The treatment consists in the exhibition of purgatives, tonics, and alteratives. Quinia is especially valuable. Ordinary E. rarely gives trouble, subsiding gradually under mild alterative treatment and rest.