The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 2).
- Date:
- 1849-59
Licence: Public Domain Mark
Credit: The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 2). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![It is frequently dependent on gastric derange- ment, and from the intimate sympathy which exists between the skin and mucous membranes, irritation of the stomach and bowels may become not only a predisposing but an exciting cause, especially when there is susceptibility to this dis- ease. On the other hand, the irritation in the skin during attacks of erysipelas frequently induces sympathetic disorder of the biliary and gastric system. Hence the origin of the term bilious, applied to those cases in which the ery- sipelatous inflammation is accompanied with gas- tric derangement. Some persons, more particularly elderly persons of a cachectic habit, and females about the period of the cessation of catamenia, are liable to peri- odic attacks of the erysipelas, which are generally preceded or accompanied by symptoms of derange- ment in the stomach and bowels, but seldom with fever. When the erysipelatous inflammation in such cases appears on the extremities, it sometimes induces thickening of the skin, and occasionally superficial ulceration, which proves troublesome and tedious to heal. Besides the origin of erysipelas from causes originating within the system itself, it appears to prevail more at certain seasons than at others. The spring and autumn are the periods of the year when it is most prevalent; it occasionally assumes an epidemic or endemic character, from which circumstance it has been supposed to be engendered by a particular condition of the air, or at all events to be materially influenced by atmos- pheric causes. There have been at various times visitations of epidemic erysipelas. It appeared at Toulouse in 1716, when from its great fatality it was compar- ed to the plague. De Haen, (Ratio Medendi) Bartholinc, (Hist. Anatom. Rat. Hist. 56) Silvius de la Boe, (Prax. Med. Appendix, tract, x.) be- sides other writers, describe an epidemic erysipe- latous fever, which was accompanied with inflam- mation in the stomach and duodeum. Bromfield (Surgical Cases and Obsei-vations) mentions erysipelas of the head, which was epi- demic for two years. Evacuations generally prov- ing fatal, it was treated by bark and cordials. [An epidemic erysipelas, known by the popular name of Black Tongue, prevailed in some parts of Indiana, in the year 1843 ; an account of which was given by Dr. Geo. Sutton of Aurora, Indiana, ( Western Lancet; Nov. 1843;) and ery- sipelatous fever'' occurred in the Northern sec- tion of Vermont and New Hampshire in the years 1842-3; which has been described by Drs. Charles Hall and George J. Dexter, (^Amer. Journ. of the Medical Sciences, Jan. 1841,) and by Dr. J. A. Allen (Boston Med. and Surg. Journal, 1844.) ] When erysipelas is epidemic, it is severe and often fatal. The inmates of crowded establish- ments, more especially of hospitals for the recep- tion of the sick, situated in the vicinity of those districts in which it is prevalent, are particularly liable to its attacks ; and so long as the epidemic prevails, the slightest causes are often sufficient to produce the disease. It is, however, more likely to occur in those persons whose health has been previously broken by protracted diseases. It is also a frequent concomitant or consequence of fever treated in hospitals, though it rarely occurs among fever patients in the better class of society When hospital erysipelas once appears in the wards, it is most difficult to prevent its spreading; and although it succeeds to operations, wounds, or injuries, or supervenes on some slight frritation of the skin, as, for instance, around the incision made by the lancet in venesection, or by the cup- ping scarificator, or appears around the leech-biles, or the margin of a blistered surface, it frequently arises spontaneously on various regions of the body, in patients whose local disease is not ac- compajiied by an external wound. It has been sometimes so formidable in hospitals, as to render it necessary to shut up particular wards, and even to delay the performance of surgical operations, the most unimportant being at such times follow- ed by severe and often fatal erysipelatous inflam- mations. W^hen erysipelas succeeds to external injuries, such as accidents or operations, it may often be traced to imprudence on the part of the patient, more particularly to errors of diet, or to mental or bodily excitement. In many instances the occur- rence of erysipelas after operations or injuries, is the result of unskilful local or general treatment on the part of the surgeon, and more particularly of the neglect of the cooling antiphlogistic treat- ment during the constitutional excitement which generally follows capital operations. Erysipelas may also arise from local irritation, long-continued or undue pressure, improper exer- cise of an inflamed part, or the application of stimulants or irritants to sound or ulcerated parts. Well-authenticated facts warrant the conclu sion, that under certain circumstances erysipelas may spread by contagion; rarely, however, in clean and properly ventilated dwellings. It is in vain to urge the fact of the disease spreading from person to person, as its propagation might be the consequence of exposure to the same causes ; but when we find persons who, after becoming infect- ed apparently from attendance on erysipelatous patients, remove as soon as they become ill to another residence at some distance, and commu- nicate the disease to the family, the irresistible conclusion is, that erysipelas in such cases has been communicated by contagion. Ample proofs of the truth of this opmion will be found on reference to the papers of Dr. Wells, (Transactions of a Society for the Improvement of Medical and Chirurgical knowledge, vol. ji.) Dr. Stevenson, (Transactions of the Medical Chirurgi- cal Society of Edinburgh, vol. ii.) Dr. Gibson, (Ibid, vol. iii.) Mr. Arnot, (London Medical and Physi- cal .lournal, March 1827,) Mr. Lawrence, (Medi- co-Chirurgical Transactions of London, vol. xiv.) and others. A short abstract of the most striking facts is subjoined. Dr. Wells was called to attend an elderly man with erysipelas of the face, which proved fatal. His wife was seized with it a few days after his decease, and also died. Five weeks after, the landlady, who resided in the same house, had erysipelas of the face, but recovered. The nurse who attended the landlady was attacked with the same disease, and died in the parish work-house. The nephew of the person first nl- tacked was taken with erysi[)elas shortly afte:; visiting his uncle, and died in a few days.](https://iiif.wellcomecollection.org/image/b21116817_0103.jp2/full/800%2C/0/default.jpg)
