FURUNCULUS, OR BOIL. 23 



has been stationary for years, when the patient is old, gouty, or a 

 high Hver ; it may be looked upon as a safety valve, and any ten- 

 dency to unite as indicative of impaired health. The sudden cessa- 

 tion of a drain of pus might be followed by hemorrhage, apoplexy, 

 or inflammation of some important organ. 



ERYSIPELAS. 



Erysipelas is an inflammation of the skin and subcutaneous cellular 

 tissue, having a tendency to spread. 



The cutaneous form is characterized by redness, elevation, and 

 burning pain ; compression produces pale dimples, which soon dis- 

 appear, and the cuticle vesicates. It usually terminates in a week or 

 two, but may return to some other part. 



The phlegmo7ious or cellulo-cutafieous form is more severe. The 

 swelling is greater, the colour darker, and the pain more severe. Thin, 

 ichorous pus is formed, which infiltrates the cellular tissue, and thus 

 ulcerations and sloughs follow. The constitution sympathizes ; at 

 first tlie fever is high, then there are signs of hectic, and at last pros- 

 tration and collapse. 



When it affects the head or throat, producing coma or dyspnoea, 

 and when it occurs in feeble, old, or intemperate persons, there is 

 great danger. 



The causes may be fatigue, foul air, intemperance, epidemic in- 

 fluence, contagion, and injuries. 



Treatment. — This must be adapted to the age and constitution of 

 the patient ; the young and plethoric will require most active anti- 

 phlogistic treatment constitutionally, whilst the old and broken down 

 will need stimulants and tonics. In most instances, bleeding will be 

 useful, followed by saline purgatives and diaphoretics. In highly 

 inflammatory cases, an emetic administered early will also prove 

 serviceable. 



Bark will be necessary in the latter stages, if there is debility ; 

 opium will allay the restlessness at night. 



The local measures most useful are leeches, punctures, cold 

 lotions, if the pulse is good ; and mercurial ointment, or nitrate of 

 silver applied to the surface. Extension of the disease may be pre- 

 vented by strips of blistering plaster, encircling the part. 



Deep incisions are to be made in case there is pus collected under 

 the skin. 



Chronic, or habitual erysipelas, is best treated by alteratives and 

 aperients. 



FURUNCULUS, OR BOIL. 



Boils occur most frequently in the young, and in those of plethoric 

 habit, and in those parts where the skin is the thickest. They are 



