Erysipelas. St. Anthony's Fire.
Erysipelas is a diffused inflammation of the skin, affecting only a part of the surface of the body, and is accompanied by a fever, which is generally thought, to be infectious and contagious. The local inflammation is disposed to spread; it extends deep, and is attended by swelling, a tingling, burning, and pungent heat, and by a redness, which disappears when the skin is pressed by the finger, and returns on remitting the pressure.
Symptoms The constitutional symptoms are chilliness and shaking, succeeded by heat; lowness of spirits, lassitude, pains in the back and limbs, pains in the head, quick and hard pulse, thirst, loss of appetite, white and coated tongue, bitterness of mouth, nausea, vomiting, pain m stomach, and costiveness.
These symptoms go before the local inflammation several days; they increase with the redness of the skin, and disappear upon its decline. The nervous system is sometimes severely affected, and indicated by low, muttering delirium. At the close of the inflammation there is generally a relaxation of the bowels, and the scarfskin peels off. Sometimes matter forms under the skin, and occasionally mortification occurs. The face is the most frequent seat of the disease. It commonly begins on one side of the nose, and soon spreads over one side of the face, closing up the eye, and changing the features in a shocking manner. See PLATE III, Fig. 1.
Somewhere about the third, fourth, or fifth day, very minute blisters appear on the inflamed parts, filled with water, which increases until the blisters break and let it out. The disease comes to a head on the eighth or ninth day, when the blistered parts dry, and the skin begins to peel off.
Treatment. In the treatment two things are to be clone, to subdue the fever, and the local inflammation. The fever is assuaged by rest, mild diet, gentle laxatives (26), (21), (125); and by the use of tincture of veratrum. For the local inflammation, various things have been advised, but nitrate of silver, on the whole, has the preference. First wash the inflamed part with soap and water to remove any oily substance, and wipe the skin dry. A solution of nitrate of silver will in many cases, according to Dr. Higginbottom, do even better. Use a solution of one dram of Argyrol to half an ounce of water that has been boiled and then cooled. Apply with a camel's hair brush over the entire inflamed area and for a small space beyond.
Apply two or three times to secure a firm coating but use carefully to avoid sloughing. A perhaps better remedy than any is to apply after washing with water and castile soap, a thick coating of iethyol with Vaseline equal parts. Cover this application with oil paper or absorbent cotton as it will stain the clothes.
In mild cases, flour may be dusted on the inflamed part from the dredging box. Warm fomentations are also useful, and cloths wet with water, and laid on. A solution of perchloride of iron, applied to the inflamed skin, is much used now, or water as hot as can be borne.
In erysipelas the powers of the system are generally reduced, and tonics, such as quinine, wine, etc., are generally required. Dr. Robert Williams, high authority in these matters, says be puts his patients upon milk diet, gently opens the bowels, and gives them, daily, from four to six ounces of port wine, together with sago, and that be seldom has to change this course, whatever the symptoms.
For the inflamed skin, a tea made of buckwheat meal is a good wash. Alcohol and water, or new rum, may be used for the same purpose.
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