Unlike to other infections fevers, erysipelas leaves a very great susceptibility for renewed attacks. Not a few persons are subject to a periodically returning form-the so-called Habitual erysipelas, which mostly affects the face or lower extremities.
Phlegmonous erysipelas is usually the result of an injury, and deep abscesses form in various parts of the body, discharging a foul, dirty pus. These cases are very serious, and often prove fatal.
Dr. H. Landerer relates the history of a case of melancholia of seven months’ standing and progressing towards incurable dementia, in which the patient, a young girl, recovered completely from her mental affection simultaneously with the subsidence of an attack of facial erysipelas spreading to the scalp. Two or three years had elapsed when the report was made, and she still maintains perfect health.
Burns has collected twenty-two cases of tumors which were the seat of idiopathic erysipelas. Three cases of sarcoma were permanently cured. In four cases of lymphoma of the neck, some of the glands entirely disappeared, and the others became smaller. In five cases erysipelas was artificially produced. Three of these cases were of carcinoma of the breast. In one of them the disease was not checked; in another the tumor was diminished to one-half its former size, and the third was practically cured, a small induration in the scar, the size of a pea, remaining. A multiple fibroid sarcoma was diminished in size, and an orbital sarcoma was unchanged.
My own observation has been limited to one case, a carcinoma of the breast. Erysipelas was artificially produced, with the result of death in about three weeks. No effect was produced upon the carcinoma.
Treatment.
Local.- The use of oven-dried rye meal, or powdered starch may afford much comfort to the sufferer. The starch, for such purpose should be carefully prepared by washing it in cold water in order to remove all foreign matters; it should then be allowed to settle, the supernatant water poured off, and the starch then slowly dried. During the drying process it should, from time to time, be broken up so as to expose fresh surfaces, thereby hastening the process. The starch is thus readily converted into an almost impalpable powder, which, when applied to the inflamed surface, promptly relieves the itching and burning. Applications containing fatty substances are usually harmful in their effects.
The following makes an excellent application in some cases: The site of the disease is to be painted with this mixture every two hours, and then covered with antiseptic gauze.
Rx Carbolic acid,
Tincture of iodine,
Rectified spirit, j.
Oil of turpentine, jj.
Glycerin, jjj.
Dr. Hilsman recommends the application of strong heat to the parts affected. This procedure is evidently homoeopathic. Erysipelas is a dermatitis of a specific character, and the application of a high degree of heat produces, itself, a dermatitis. Whether the high heat kills the microbe of erysipelas or not does not affect the homoeopathicity of the treatment. The parts attacked by erysipelas are covered with heavy felt and then a red-hot smoothing iron applied forward and backward over the felt which heats the affected parts and removes the erysipelas. Some cases are intolerant of heat.
The external application of raw cotton to the inflamed parts, to keep off the air, as in burns, is recommended by several physicians.
I have found the application of Verbascum vir, one teaspoonful of tincture to half a glass of warm water, to be very soothing.
In domestic practice a poultice of raw cranberries, or scraped potatoes, or raw carrots, is often uses with decided benefit.
The indications for remedies are as follows:
Aconite.- Intense synochal fever, with restlessness, fear of death, etc.
Ammonium carb.- Erysipelas of old people, when cerebral symptoms are developed, while the eruption is still out; debility and soreness of the whole body; tendency to gangrenous destruction.
Anthracin.- Erysipelas gangrenosa with typhoid symptoms; great pain in head and dizziness; delirium and unconsciousness; great prostration and depression; fainting and copious sweating; sleep short, unrefreshing, more like stupor.
Apis.- Erysipelas, with bruised sore pain and much swelling; stinging, burning, prickling pains in the skin, which is very sensitive to the slightest touch; erysipelas of the face and scalp, with puffiness of the eyelids; typhoid tendency; sphacelated spots here and there; the whole eruption rather pale that deep red; chronic erysipelas, recurring periodically; apt to go from right to left.
Arctium lappa.- Chronic erysipelas is said to be removed permanently by its persistent use. (Gymnocladus Ptelea.)
Arnica.- Phlegmonous erysipelas, with extreme tenderness and painfulness on pressure, with tendency to the formation of bullae; the swelling hot, hard, shining, even deep red; the patient feels nervous, cannot stand pain, and feels tired as after hard work, or as if beaten.
Arsenic.- Irregular progress; disposition to internal organs; terrible restlessness and sinking of strength; fainting pain in the bowels and hemorrhage, as sometimes occurs in large burns.
Belladonna.- Intense erysipelatous fever, accompanied by inflamed swellings, passing even into gangrene; skin imparts a burning sensation to the examining hand; phlegmonous erysipelas; tendency to attack the brain, with delirium; severe headache, furious look, violent thirst, dry tongue, parched lips, etc.; smooth and shining erysipelas on the right side of the face; tendency of inflammation to spread in streaks.
Borax.- Erysipelas of the left side of the face, painful when laughing, with sensation as if covered by cobwebs.
Bryonia.- Erysipelas articulorum, with drawing-tearing pains, increased by motion.
Camphora.- Great exhaustion; coldness of skin; breathing scarcely audible or visible.
Cantharides.- Typhoid erysipelas; vesicular erysipelas, with fine stinging-burning pains internally and externally, the patient being uneasy, restless, distressed, dissatisfied, unquenchable thirst, with disgust for all sorts of drinks; kidneys and bladder involved; erysipelas begins on dorsum of nose and spreads to both cheeks, but more to the right.
Comocladia.- Burning on face and eyes, worse to wards evening; excessive swelling of the face, with tormenting thing and swelling; corrosive itching of the head; dizziness and heaviness of the head, with shooting pains, relieved by motion.
Croton tigl.- OEdematous swelling of eyelids; large and small blisters; intermediate skin cracked and peeling off; violent burning.
Cuprum.- Sudden sinking of the swelling and changing into a bluish color; violent brain symptoms.
Euphorbium.- Erysipelas of head and face, with digging, boring, and gnawing pains, followed, when ameliorated, by creeping and itching of the part. Considerable swelling of the parts affected, with small vesicles discharging a rather yellowish fluid.
Eucalyptus glob.- General erysipelas, with putrid dysenteric passages; typhoid symptoms. A desire to be constantly moving about.
Ferrum phos.- Rose and erysipelatous inflammations of the skin, for the fever and pain and severe symptoms of inflammation.
Graphites.- Chronic disposition of the disease to return, from right to left; phlegmonous erysipelas of head an face, with burning-tingling pains; swelling and induration of lymphatics and glands; very liable to take old from the least cold air.
Hydrastis.- Wandering from left side of nose to right over whole face and scalp; intense pain in the lumbar region chills down the back; extremely restless; disturbed by noise; delirium; urine suppressed.
Hydrophyllum Virg.- Burning and watering of eyes, with slight itching. Eyelids swollen, sclerotica injected, fiery redness, sensitive to light. In the morning eyelids agglutinated.
Ipecac.- Retrocession of eruption, with vomiting.
Kali carb.- From right to lift side; oedematous swelling under the eyebrows. When touched ever so slightly on his feet, he jerks them up much frightened; he talks of pigeons flying in the room, which he tries to catch with his hands; he gets regularly worse about 3 o’clock A.M. After previous attacks.
Kali mur.- Schussler says this is the chief remedy in vesicular erysipelas.
Kali sulph.- Blistering variety, to facilitate the falling off scabs.
Lachesis.- Where the cerebral affection does not yield to Belladonna; bloated red face, attended with heat; headache and coldness of the extremities; one-sided tense headache, extending from occiput to eyes, with vomiting, vertigo, tendency to faint, and numbness; left side especially affected. (Belladonna, right).
Ledum.- Erysipelas of face and eyes from bites of insects.
Natrum phos.- Erysipelas, smooth, red, shiny, tingling or painful swelling of the skin.
Natrum sulph.- For the smooth form, with or without vomiting of bile.
Natrum benzoicum- Dr. Haberkorn uses this drug in full physiological doses and given in seltzer water. He has treated fifty cases without a death, and reports that almost uniformly within forty-eight hours the temperature was reduced to normal, and the patient felt well. The local symptoms quickly subsided, ending with desquamation. No local treatment was used.
