Symptoms.—The disease usually begins at the ear or one side of the nose, and redness and swelling extend over that side of the face; more rarely it crosses over the median line and affects the whole of the upper part of the face. Pain and tingling precede the inflammation, and when the latter has reached its height, the eyelid is so swollen that it cannot be opened; the ear is large, red and flabby, while the skin adjacent is swollen, red and painful. Erysipelas is, in fact, an inflammation of the skin, and it is severe according to the depth to which this tissue is implicated. Sometimes only the upper layer is affected, and then the appearance is like that seen in erythema, diffused redness of the skin produced by capillary congestion. There is but slight swelling, and the constitutional symptoms are not severe. But if the whole thickness of the skin be attacked, and, in addition, the loose cellular tissue underneath, then the inflammation is of graver import, and may spread over a large area. A high temperature, quick pulse, thirst, often a sore throat, loss of appetite and a thickly-coated tongue, are among the earliest symptoms. The patient feels very restless and sleeps badly at night: in many cases delirium comes on towards evening: mostly observed in those previously addicted to intemperate habits. The bowels are often constipated, and the urine high coloured and containing a little albumin. Erysipelas of the face without other complications usually runs a course of 6 or 7 days, when the temperature rapidly runs down, the tongue begins to clean, and all the febrile symptoms disappear, leaving the patient weak and anaemic. If, however, the inflammation has affected the deeper layers of the skin, or if the patient has been previously in bad health, matter or pus may form beneath the scalp through the spreading of the disease upwards: when this occurs the pus soon burrows about under the scalp, and an opening must be made to allow the matter to discharge.
Treatment. The patient must be kept in bed and fed on light and nourishing diet. The light should be kept from his eyes and access of air to the inflamed skin prevented by dusting the surface with flour, or smearing the part gently with a mixture of equal parts of castor-oil and collodion, or castor-oil alone. This effectually keeps off the air and relives the tightly-stretched skin. Some opening medicine may be given at first, if constipation is present and the tongue is much coated. Steel drops are a useful medicine in this disease: they should be given in doses of from 15 to 20 drops, with the same quantity of glycerine, in a little water, every 3 or 4 hours. Larger doses are frequently administered, but it is better not to give these unless ordered by a medical man. During convalescence, tonics containing iron and quinine may be given, and for some time all exposure to cold winds, etc. should be avoided.
'Chicken-pox, Diphtheria, Measles, Mumps and Whooping Cough, being more frequently contracted in childhood, are dealt with in the section Diseases of Children. All of these complaints, however, may be developed by adults.
