ERYSIPKLAS. 273 



il because from ti. J of the 



blood .United, aii-l tl at may 1. y bad throat 



with.. .in or distress in that region. An occasional hurried 



;ition, or lueness of the lips or finger-nails, may, if looked for, call 



i'Mi to tlic nature of the impending mischief. In general the temperature, as 



i l.v tin- tliermometer, rises rapidly at the onset of the disease, reaching 



or more, in the course of a few hours. So long as the inflammation of 



tin- skin continues to spread the temperature increases, and may attain 106. 



:i (1 f t'-mperature is to be regarded as an indication of the spread 



of disease. During the period of convalescence, a sudden increase in the fever may 



be an accompaniment or the herald of a relapse. Such a relapse might possibly be 



temporarily overlooked were it not for the use of the thermometer, for the symptoms 



i {most imperceptible to the patient, and they may occur in a situation not 



osed to the eye of the physician. The fever, as measured by the 



tht-rmometer, is very variable in duration, and the temperature, after having 



returned to the normal, may exhibit several re-elevations coincident with extensions 



of the inflammation. Usually the highest temperature is reached on the third day 



of the eruption, and the decline commences on the fifth or sixth day. In fatal cases 



death tak-s place with very high temperature. 



The pulse is generally full, beating at the rate of from 100 to 120 in the minute. 

 It may revert to its normal rate at the end of the third or fourth day of the 

 eruption, not again to rise far above this, unless indeed there be a relapse, indicated 

 by elevation of the temperature. 



That form of erysipelas which attacks only the skin is much less dangerous than 

 that which involves the deeper parts. Cases which occur in patients with an open 

 wound are of much more serious import than those wliich originate spontaneously. 

 The termination of the disease is also less likely to be favourable when it occurs in 

 an epidemic form. 



The disease is always more serious in old people and children than in young 



>us adults. The habits and health of the patient previous to the attack great ly 



influence the result. Erysipelas, like many other diseases, proves especially fatal 



to drunkards and those w^hose health has been undermined by excesses of any 



kind. 



nt of the inflammation is usually of not so much importance as the 



i the constitutional symptoms. "When there is a rapid, weak pulse, with a 



dry, brown tongue, or low muttering delirium, with marked prostration of strength, 



is very serious, even though the local changes may be limited both in 



distribution and severity. 



The occurrence of delirium, and especially of delirium at night, is of no great 

 importance, but marked drowsiness alternating with delirium is a serious symptom. 

 Sometimes the membranes of the brain become involved, but delirium is not of 

 necessity an indication of the occurrence of this complication. 



W. now pass on to the consideration of the best methods of treating erysipelas. 

 The attendance of a medical man is in all but the very slightest cases absolutely 

 necessary. The patient should be confined to bed, and attention should be paid to 

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