ERYSIPELAS. 271 



afternoon, cannot possibly hurt anybody ; and if you can only get him to take an 

 iutrivst in his work and like it, it may do him a great deal of good. In epilepsy, as 

 in other chronic diseases, cod-liver oil, quinine, and other general remedies may be 

 given, when there are special indications for their employment 



ERYSIPELAS. 



This is the disease which is commonly known in England as "St. Anthony's 

 iind in Scotland as " the rose." Two different forms of erysipelas are usually 

 recognised " idiopathic " erysipelas, arising from constitutional causes, and attacking 

 c-lii.-tly the head and face; and "traumatic" erysipelas, which follows a wound or 

 injury, and may occur on any part of the body. The former variety, of which 

 chiefly we shall have occasion to speak, is to all intents and purposes a fever, and 

 belongs to the same class of diseases as small-pox, measles, and scarlet-fever. There 

 is reason to believe that erysipelas is catching, although its contagiousness is un- 

 doubtedly of a low order. It not unfrequently occurs as an epidemic ; but it is far 

 more common to find it haunting certain localities, and becoming what is called 

 "endemic." 



The causes which are usually said to produce erysipelas are both numerous and 

 diverse. Certain individuals, and even certain families, appear to be more liable to 

 suffer from the disease than others. What is the cause of this special susceptibility 

 it is impossible even to conjecture. Erysipelas is common in newly-born children, 

 but from the first to the twentieth year it is by no means common ; after this period 

 to the fortieth year it is frequent as an acute disease ; but in more advanced age it 

 occurs cliiefly as a chronic and less important malady. It is often said that women 

 suffer from it more frequently than men, and that it is especially liable to make its 

 appearance at the time of the monthly periods and at the change of life, but these 

 statements are not altogether borne out by facts. Gouty people have been found to 

 suffer from it more frequently than others. Errors in diet, and especially eating 

 certain indigestible substances such as shell-fish, and improperly smoked, dried, 

 salted, or preserved meats, are said to act as exciting causes. Violent mental 

 emotions are also accused of being occasionally the cause, and it is said to have been 

 brought on by both anger and fear. Sometimes no cause can be assigned for its 

 onset, but its occurrence is promoted by all circumstances that tend to debilitate the 

 body by intemperance, by previous disease, by low spirits and anxiety, by insuffi- 

 cient nourishment, and by foul air. Formerly, when less attention was paid to 

 cleanliness and ventilation, it was much more common in hospitals and infirmaries 

 than at present. Injuries to the skin, such as abrasions, scratches, wounds, burns, 

 or blisters, wherever they are situated, may be the starting-point of the inflamma- 

 tion. Sometimes even the presence of gout in a particular joint, or the irritation 

 caused by diseased teeth in either the upper or lower jaw, may determine the seat 

 of onset. It is probable that the most common cause of an attack of erysipelas is 

 its communication from one person to another. In erysipelas the constitutional 

 symptoms may precede the local, or redness of the skin may make its appearance 

 before the fever commences. The former course is the more common. 



