274 VETEKINABY MEDICINE AND SURGERY. 



son: In the cellulo-cutayieous variety, which is probably the most com- 

 monly met with in the lio?se — indeed there is some doubt whether in him 

 the skin is ever, in a pure and uncomplicated form, the seat of this mor- 

 bid action, bat is not in every form complicated with the invasion more 

 or less of the subjacent cellular tissue — the effusion into the subdermal 

 connective structure is at first purely serous, and consequently the swell- 

 ing resulting from this infiltration pits easily on pressure, the indenta- 

 tion being as rapidly filled up again Avhen the pressure is removed. As 

 the disease advances, however, the effusion is more strictly inflammatory, 

 the pain is greater, the skin feels resisting, tension being increased; the 

 material extravasated is less susceptible of indentation when pressed 

 upon, and the parts acquire a firm, brawny feeling. 



The presence of numerous well-defined vesicles, although a character- 

 istic symptom of the disease, is nevertheless.not met with in every case, 

 and the serous exudation found jDreceding as well as accompanying them 

 occurs at intervals over considerable areas of the skin. The tendency of 

 the epidermis to become detached is well shown by pressing on the vesi- 

 cles, Avhen the contained fluid is readily distributed over a large surface; 

 while the character of this fluid may be taken as a fair criterion of the 

 severity or malignancy of the seizure: it is more truly serous in the 

 milder forms, and bloody and albuminous in the less benignant. 



When the inflammation in the subcutaneous tissue has terminated in 

 the process of suppuration, or when patches of skin are losing their vital- 

 ity, ultimately to be removed by sloughing, the hair falls off or is easily 

 removed, and the skin appears of a leaden hue and of a moist feeling. 



The recognition of erysipelas, although ordinarily not a difficult mat- 

 ter, may in particular instances be confounded with some of those dis- 

 turbances in which haemal contamination is a prominent feature, as scar- 

 latina or purpura, with acute farcy, or with lymphangitis. With the 

 exercise of a little care, however, it is easily enougii differentiated from 

 all of these. From scarlatina it is distinguished by its non-association 

 with a previously diseased condition, and by, in the severer cases, the 

 more sthenic character of the pyrexia! and inflammatory symptoms. In 

 erysipelas the tumefaction of the limb is uniform and firm, not in patches 

 as in scarlatina; although both have oozing of serous fluid from the skin, 

 the manner of oozing is different. In erysipelas pain on manipulation is 

 more marked, while in scarlatina there are no circumscribed or diffused 

 ruptures of the cutaneous tissue; infiltration and swelling of gland-tex- 



