SUPPURATION, PYiEMIA, SEPTICEMIA, EKYSIPELAS. 



185 



Erysipelas. 



Erysipelas is an acute inflammation of the skin, occurring in 

 connection with wounds, when it is traumatic, and on surfaces 

 apparently sound, when it is idiopathic, as in erysipelas of the 

 face. It is highly contagious in surgical wards, and it gives rise 

 to rapidly fatal puerperal fever in lying-in hospitals. In such cases 

 the virus is obviously conveyed from sick to healthy persons by 

 direct contact, or by instruments and sponges, or by the hand 

 of the surgeon, physician, or nurse, and possibly by the air. 



Fig. 88. — Section of Skin in Erysipelas. 



v,v, two lymphatic vessels containing leucocytes and m,m, streptococci ; t, connective 

 tissue ; a, connective tissue and wandering cells, x 600 (CoENiL and Ranvikr). 



Streptococcus of Erysipelas In 1882, Eehleisen isolated a 



streptococcus in erysipelas, described the appearances on cultivation, 

 and maintained that it could be distinguished from the streptococcus 

 of suppuration. Rosenbach agreed that the two micro-organisms 

 could be distinguished by parallel experiments, and named the one 

 Streptococcus pyogenes and the other Streptococcus erysipelatis. 

 (Fehleisen). Rosenbach asserted that the colonies of the latter 

 were more opaque and whiter than those of Streptococcus pyogenes 

 and the growth more marked in the depth of nutrient gelatine, 

 while microscopically the chains were better marked and larger, and 

 the individual cocci larger than in Streptococcus pyogenes. Others 

 who investigated this subject could not distinguish them with 

 certainty, either by their morphological or cultural characters or 

 effects on inoculation. Passet found that inoculation of Strepto- 

 coccus pyogenes induced a CQndition very similar to that produced by 

 inoculation of Streptococcus erysipelatis. HofFa and Hajek described 

 minute differences, but Biondi and Eiselsberg failed to confirm these. 



