Page:The American Cyclopædia (1879) Volume VI.djvu/733

ERYSIPELAS subcutaneous cellular tissue. Idiopathic ery- sipelas almost invariably attacks the face ; frequently it is preceded by loss of appetite, languor, headache, chilliness, and frequency of pulse ; a deep red spot now makes its ap- pearance, commonly on one side of the nose, swollen, firm, and shining, and is the seat of a burning, tingling pain. The disease gradually extends, often until the whole of the face and hairy scalp has been affected, but it is exceed- ingly rare for it to pass upon the trunk. Often, while it is still advancing in one direction, the part originally affected is restored to its normal condition. Commonly large irregular vesicles (phlyctence) filled with serum, precisely similar to those produced by a scald, make their ap- pearance on the inflamed skin. The pulse is frequent, there is total loss of appetite, head- ache, prostration, restlessness, and sleepless- ness, and commonly, particularly at night, more or less delirium. The complaint runs its course in about a week, and the general symp- toms ordinarily abate somewhat before any decline is noticed in the local inflammation. In itself erysipelas of the face is ordinarily un- attended with danger ; but where it occurs in the course of other and exhausting diseases, it adds much to the gravity of the prognosis. In fatal cases the delirium is apt gradually to lapse into coma. Erysipelas is subject to epidemic influences ; in certain seasons it is exceedingly prevalent, while in others it is rarely seen. The attack is favored by overcrowding and deficient ventilation. Hospitals, particularly in spring, are infested with it. Certain unhealthy states of the system predispose strongly to the disease, and an unwholesome diet and the abuse of alcoholic stimulants are commonly cited among its causes. "We have seen that simple erysipelas is rarely fatal ; consequently recoveries are common under a great variety of treatment. Usually it requires nothing more than to move the bowels by a mild lax- ative, and afterward to support the system by the administration of nutriment, and if neces- sary the use of quinine and wine whey. Where there is great prostration, stimulants may be administered freely. Systematic writers make a separate variety of the erysipelas of new- n children ; it presents no peculiarity, how- ir, except its greater gravity, in common nth other diseases, in such delicate organisms. Then erysipelas of the abdomen occurs in 3w-born children, it commonly has its point of origin in the recently divided umbilical cord. In some cases erysipelas, arising gene- rally from some injury or excoriation, shows a tendency to advance in one direction while it passes away in another (erysipelas ambulans) ; in this manner it may pass over almost every part of the surface. In phlegmonous erysip- elas the precursory symptoms are more con- stant and severe, the pain more violent, the prostration greater ; the redness is most strongly marked along the trunks of the lymphatic vessels, and the lymphatic glands are swollen ; ERYTHRAEAN SEA 721 the swelling of the skin is more considerable it soon assumes a pasty consistence, and pits strongly on pressure. As the disease advances the pain subsides, the redness is diminished' and fluctuation becomes evident ; if left to it- self, the skin, gradually thinned and distended sloughs over a larger or smaller space, and pus mingled with shreds of dead cellular tissue is discharged. The disease indeed seems usually to be in the cellular tissue rather than in the skin, and sometimes the cellular tissue through- out a limb appears to be afiected. It is a dis- ease of great severity, and when extensive often proves fatal under the best treatment. In its treatment, the same general principles apply as in simple erysipelas. The patient's strength should be supported by a nutritious diet, and tonics and stimulants must often be freely administered. Early in the disease the skin should be freely divided down into the cellular tissue, to relieve the constriction of the parts and afford an opening to the discharges. ERYTHEMA (Gr. epvBaiveiv, to redden), an affection of the skin characterized by a slight redness without determinate form. It is gen- erally due to the action of some special cause, as the heat of the sun, &c. "Where it is pro- duced by the friction of two contiguous sur- faces, as frequently occurs in infants and in fleshy persons, it is often called intertrigo. Erythema nodosum, the severest form of the disease, is characterized by the eruption of numerous red spots from one third of an inch to an inch in their longest (vertical) diameter. These spots are slightly elevated ; after a few days their color deepens, and passing through various shades of blue and yellow, the skin resumes its normal color. The affection is apt to be attended with fever, depression of strength, and derangement of the digestive organs. Simple erythema needs no treatment beyond the employment of soothing applica- tions; in intertrigo, the use of an absorbent powder, as lycopodium, starch, &c., may be advisable. Erythema nodosum is best treated by diet, rest, and a mild laxative ; in some cases tonics and iron are useful. ERITHR.aEAN SEA (Gr. IpvOpfa, epvflpaiof, red, ruddy), in ancient geography, originally the name of the whole expanse of sea between Africa on the S. W., Arabia on the N. W., Gedrosia on the N"., and India on the N". E., including the two great gulfs, the Arabian and the Persian. In this wider sense the term seems to have been used by Herodotus, who designates by it both the Indian ocean, of the shape of which he was ignorant, and the Persian gulf, distinguishing the Red sea, the yam suf or weedy sea of the Hebrews, which he calls the Arabian gulf. The term f] vorlrj Qakacaa (southern sea) appears in some pas- sages of the same historian as identical with the Erythrasan, in others as designating the more distant and less known region of the latter. Later and better informed geographers, distinguishing the separate parts of the sea,