Nux vomica.- Gastrosis the cause of the erysipelas; burning itching all over the skin, worse in the evening; great debility, with oversensitiveness of all the senses, and irritability of temper.
Pulsatilla.- Erysipelas erraticum; bluish, spreading rapidly, especially about buttocks and thighs; smooth skin, headache; mucous diarrhoea, nausea, neither appetite nor thirst.
Rhus rad.- Phlegmonous erysipelas, especially when it begins in the ankle and moves gradually up the leg in the deeper tissues; sometimes with very little fever.
Rhus tox.- Vesicular erysipelas; itching all over, especially on hairy parts; after scratching burning; swelling and redness of the face, with partial or entire closure of the eyelids; bruised feeling in the limbs and back; tendency to attack the brain; dark bluish redness of the parts affected.
Rhus ven.- The symptoms usually begin by itching and tumefaction in the hands and face, the swelling gradually spreading over different parts of the body.
Ruta.- In combination with wounds.
Sulphur.- Erysipelas migrans, appearing in subsequent throes, and running its course for a longer time than usual. Helps often when all other remedies fail.
Terebinthina.- Erysipelas bullosum, skin red and indurated, swollen, clusters of small, flat, pale, yellow vesicles, often confluent, with large red halos, here and there turning bluish- black, showing a tendency to gangrene.
Trichlorphenol.- The daily application of a 5 to 10 per cent. solution of Trichlorphenol by means of a brush to an erysipelatous surface has been accompanied by excellent results.
Veratrum vir.- Right side of head and face much swollen and covered with large blisters; headache; high fever; no sleep; no appetite; intermitting attacks of nausea; occasional vomiting of the water drank. It was applied low, externally and internally.
Rubella.
There is a form of eruption which resembles measles, but differs in several particulars, and about which some dispute exists. It has received several names, as, for example, rubeola notha, roseola, rotheln, rosalia, German measles, etc. Rubella is undoubtedly the proper term for this rose-red colored eruptive fever. Very little is written of it in out text-books, although it is a disease of frequent occurrence. It is probably contagious, and is more prone to be epidemic than either measles or scarlet fever. One attack usually protects from subsequent invasion, but does not protect from either measles or scarlet fever.
Rubella occurs chiefly the ages of three and twelve years. It may be seen in infants, rarely adults, and is characterized by stages of incubation, invasion, eruption, and decline, and closely resembles measles in some cases, and scarlet fever in others.
The history of the patient will aid diagnosis. Has the child had either scarlet fever or measles? Are either or these diseased existing epidemically? The stage of incubation varies from four to twenty-one days. The invasion stage in from twelve to twenty- four hours. Catarrhal symptoms absent, though the fauces are reddened. One of the most characteristic symptoms of rubella is the enlargement and induration of the cervical, post-cervical and post-auricular glands. Occasionally only a few of these glands may be affected, but more often the entire chain, also the lymphatic glands in other parts of the body, may be involved.
The eruption may first appear, like the eruption of measles, upon the face, but spreads more rapidly over the surface, or it may appear over the whole surface at once; it is most intense during the first day; it may rapidly fade in one part and appear in another; in color it is of a pale rose-red, but not so red as scarlet fever, nor so bluish as measles.
Over the more vascular parts it is often slightly elevated, with a tendency to become confluent. In other parts it is more maculate in from and of a much higher color in the centre; nor do we have the characteristic odor so peculiar to measles. The tongue is usually slightly coated and cleans in patches, producing the so called “mapped tongue” but never the strawberry tongue. Desquamation is slightly branny, and follows the eruption in nearly every case. In some cases it is well marked; in others; however, it may only be observed on some particular parts, as about the nose, and may last for three weeks or more. The patient very quickly recovers; there is no dropsy or renal disease following in its wake.
For internal remedies consult Rubeola.
Framboesia, or Yaws.
This disease is confined almost exclusively to the negro race; it originated on Guinea coast of Africa. It is a constitutional disorder, attended often with fever, and by a peculiar papular eruption, sometimes having almost a crimson appearance like that of a wild raspberry, hence its name. Its probable cause was syphilis, spread among the negroes of West Africa by the English traders. Proofs of its venereal origin are as follows.
1. That it is contagious, and can be inoculated in the same manner as matter taken from an indurated chancre.
2. It is accompanied by ulcerated throat and pains in the bones.
3. The eruption is of a secondary specific type, though not of the usual lean-ham color but yellowish-white, having an ulcerative tendency.
4. It is transmitted by parents to their off spring.
5. Such children infect those who suckle them.
6. The disease is much improved by mercurial treatment.
7. The pathological histology of the papules resembles the tissues found in syphilitic gummata.
The disease begins with malaise and fever, pains in the head and bones which are worse at night, and ulcerated throat. The body becomes covered with yellowish-white patches of varying size, with the formation of papules which break down and ulcerate under a scab with great loss of tissue. The eruption generally breaks out in the face, the neck, the upper and lower extremities, the parts of generation, the perineum, the hips, and about the anus. They are much less frequently observed about the trunk and are not so often seen on the hairy scalp. They may form on the nostrils where the mucous membrane joins the skin, and here the yaws may assume an elongated form, nearly closing the nostril, and hanging down on the lip. The same form may be observed about the eyelid. Near to the mouth they may appear in such numbers and so closely set together as to form almost a ring round the mouth. This is especially the case in children. Around the anus also they sometimes coalesce and form one projecting circular band an inch and more in breadth.
An attack of framboesia varies much in severity as regards the size and number of actual yaws.
After the disappearance of the yaws without ulceration, a dark spot is left where each law has been and of corresponding size. These spots are of deeper shade than the natural black of the skin, and they remain for many years, but may possibly wear out in time. the skin is quite smooth, and the texture uninjured. In white skins the spots are of lighter hue than natural. When, however, the disease ulcerates scars are left.
Should yaws not properly develop its several early stages the general health suffers, the patient becomes cachectic, unhealthy ulceration appear over the body, especially about the joints, which swell and become painful, and offensive effluvia are given off from the body, and the attacked dies a lingering death, or becomes crippled, more or less, by the deep ulcerations.
The mercurial preparations, and Jatropha curcas, are the principle internal remedies.
