2/2 LYMPHANGITIS. 



charge more or less of a not very well-conditioned pus, leaving" 

 an angry-looking sore, which, after a little, is disposed to heal. 

 The abscesses are generally situated in and confined to the 

 subcutaneous connective-tissue, and only implicate the skin in 

 the process of pus-formation by the pressure of contained fluid. 

 They are usually found in the vicinity of joints, with which 

 I have never seen them communicate ; the sheaths of certain 

 tendons, however, are sometimes involved. 



Diagnosis. — The diseased conditions with which lymphangitis 

 may be confounded are those where we find local swellings or 

 infiltrations, accompanied with constitutional fever, as the 

 diagnostic features. Both of these conditions, the general and 

 local, are seen in ' Purpura hemorrhagica,' ' Erysipelas,' ' Scarla- 

 tina,' in ' Farcy glanders/ and some other affections. From 

 all these, however, it is sufficiently distinguished by variations 

 in the local symptoms chiefly, which ought to prevent any 

 careful observer from mistaking it for any of them. 



From purpura it is to be distinguished by the absence of 

 swellings about the head and throat, which are so common in 

 that disease ; while the tumefaction of the limbs in purpura, 

 when these occur, are totally different. In lymphangitis the 

 swellings extend over the whole limb, beginning in the inguinal 

 region, and moving downwards ; in purpura they may start into 

 existence on any part of the surface in the form of circumscribed 

 patches. In this disease there are no blood-markings or 

 petechise on mucous membranes, and no effusion of blood as in 

 purpura. With erysipelas it is more likely to be confounded; 

 stiU the character of the local swelling is different. In that 

 disease the swellings, equally painful as in l^Tnphangitis, start 

 into existence, not at the glands in the superior part of the 

 limb, but usually in the median portion ; these are also more 

 disposed to form open sores by sloughing of the skin, while 

 petechine and blood-markings on exposed membranes are not 

 uncommon. From scarlatina it differs by the absence of 

 angina, the want of the blood-markings on the visible mucous 

 membranes, and from the fact that the local changes of the 

 skin are, in scarlatina, quite superficial, and do not seem to 

 affect — certainly not by inflammatory action — those tissues 

 subjacent to the skin. 



With farcy it has, in common, an inflamed and swollen con- 



