90 PERSONAL APPEARANCES IN HEALTH AND DISEASE. 



signs of inflammation. The cause of the red rash in scarlet 

 fever is congestion of the vessels of the skin, and its ready 

 paling on pressure of the skin shows that the blood can 

 be displaced from the vessels of the surface. Permanent 

 congestion, leading to permanent redness of parts, are 

 not at all uncommon ; and the enlarged congested vessels 

 can be traced on many a weatherbeaten face, or in the 

 bloated, reddened features of the habitual drinker. Tem- 

 porary flushing of the cheeks apart from blushing, but 

 doubtless conveyed through the medium of the nervous 

 system is seen frequently in indigestion, and is the usual 

 result of the ingestion of stimulants, as alcohol ; and an 

 aggravated degree of this produces what is known as 

 " nettle-rash." 



When the blood cannot be perfectly oxygenated in 

 the lungs, or when from any cause the return of blood 

 to the heart is hindered, then the surface assumes more 

 or less of a bluish or livid tint. This is seen best in the 

 parts which are most vascular, e.g., the mucous mem- 

 branes, as the lips, or the regions most remote from the 

 centre of the circulation, as the tips of the fingers, or toes, 

 ears or nose. Simple exposure to cold will do as much, 

 causing temporary stagnation of the blood in these remote 

 regions of the body. Prolonged chilling of the surface is 

 always followed by reaction ; the blood flows back to the 

 part with increased vigour, and redness replaces pallor, 



