Symptoms. 



221 



40). The swellings often grow rapidly assuming great dimen- 

 sions, so that the outline of the affected part of the body which 

 is much deformed, becomes lost. In severe cases the circum- 

 ference of the extremities becomes enormous, so much so that 

 sometimes the legs from the coronary band to the elbow or 

 to the knee swell to 2 or 3 times their normal size, and they 

 appear like posts on which some transverse furrows are the 

 only indications of the joints. On the head the swelling first 

 affects the alae of the nose and the lips, soon however the lower 

 part of the face becomes affected, and the fore part of the head 



Fiff. 



39. Purpura hcinorrhmjku. Eruptions resembling urticaria at the beginning 

 the disease. 



may become so broad that the transverse diameter greatly ex- 

 ceeds that of the upper portion of the head, the nose piece of 

 the halter making a deep impression, and the head in such cases 

 resembles somewhat the head of a rhinoceros (Figure 40). The 

 swellings are characterized by being always sharply defined 

 from the healthy surrounding parts. They are firm, almost of 

 the hardness of a board, so that the surface may be pitted only 

 with difficulty, the resulting depressions disappearing but slowly. 

 The skin over the swelling becomes stretched, and from 

 its surface a yellowish tenacious serous fluid oozes out which 

 later dries, forming brown crusts. In the flexor side of the 



