Inflammation of the skin only, is marked by bright redness, not
circumscribed, and disappearing when pressed. By pressure, the
bloodvessels are emptied for a time, the part sinks and becomes pale;
but, on removing the pressure, it soon regains its former colour and
relative situation; when these circumstances concur, the part is said
to pit. There is no tension,—the pain is not throbbing, but of a
burning or itching kind, and there is often a degree of _œdematous_
swelling. Swelling does not occur to any great extent, however, during
the existence of the inflammation in the skin and rete mucosum;
but the parts sometimes become much swollen after subsidence of
the inflammatory action, the vessels having relieved themselves by
effusion of serum; and afterwards the œdematous surface often assumes
a yellowish hue. In some cases, the serous effusion is from the
first, more extensive than in others, and hence the term _œdematous_
erysipelas, or inflammatory œdema. Upon the decline of inflammation, a
serous fluid is often effused also in great quantity under the cuticle,
giving rise to vesications, resembling the blisters produced by the
application of boiling water to the skin; and from this circumstance,
erysipelas has been classed amongst cutaneous affections in the order
bullæ. The erysipelatous redness does not terminate abruptly, and is
not defined by a distinct boundary, as some have asserted, but becomes
gradually lost in the surrounding parts. It frequently involves the
contiguous parts one after another, and extends with great rapidity.
It often leaves one part suddenly, and attacks another, either in the
neighbourhood, or situated at a considerable distance; in other words,
metastasis takes place. The disease takes on this erratic character
without our being able to assign any good reason for it; and this form
of the disease is frequently attended by symptoms of typhoid fever.
When it disappears suddenly, or is repelled by cold applications,
affections of the internal organs sometimes supervene, as of the
bowels, lungs, or brain; the diseased action leaving the external
surface, and attacking the deeply-seated organs; thus, in a case of
erysipelas of the ankle and foot, the external symptoms disappeared
suddenly, and an affection of the lungs supervened, under which the
patient sunk; and in erysipelas of the face and scalp, the sudden
disappearance of the redness is frequently followed by delirium and
coma. Again, in acute disease of an internal part, the symptoms are
much meliorated, and often entirely removed, by inflammation of the
skin being induced artificially, or occurring spontaneously.
The integuments of the face and head are frequently attacked by
erysipelas, in consequence of wounds and bruises of the face or scalp,
even though very slight, and it often takes place here spontaneously,
as in other parts of the body.
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