If it is more desirable to cover the granulating area by means of skin grafts it may be accomplished readily, as later described. This is usually resorted to when there has been loss of tissue from the result of sloughing, although a sliding-flap operation may overcome the defect to a nicety; this is especially true of wounds about the anterior nasal border. If the resulting cicatrice is no larger than the gaping wound it may be excised, the skin at either side is undermined and the edges are brought together, as was originally intended. ERYSIPELATOUS INFECTION It sometimes happens that a wound takes on erysipelatous infection. It is usually of the simple variety, although the cellulo-cutaneous variety is not rare. =Causes.=—The predisposing causes are septic infection, lowered vitality, resulting from alcoholism, poor hygiene, and nephritis. The exciting cause has been accredited to the erysipelo-coccus of _Fehleisen_, which is found chiefly in the more superficial channels of the corium and appearing in chain groups as seen microscopically. =Symptoms.=—The symptoms locally are the peculiar rosy rash, rapidly spreading out from the wound with well-defined margins. The affected part appears smooth and edematous and is slightly raised above the surface, the patient complains of stiffness and burning pain in the part. Often vesicles form on the affected part. The temperature rises suddenly to 102° to 103° F., there is nausea and vomiting. =Treatment.=—The wound in such cases must be treated as described in inflammatory fever. Internally the usual remedies are given. A local application of sixty-per-cent ichthyol ointment, covered with salicylated cotton, serves best. The skin may be incised in various places, washed with an antiseptic (sublimate solution 1-1,000) and the serous exudation pressed out with the sterilized hand, after which the above ointment is applied under absorbent cotton (Glück). Antithermic remedies, as obtained by the application of certain alkaloids, such as cocain, spartein, solanin, helleborin, have been successfully used by Guimard and Geley. Spartein is especially claimed to exert a happy influence. Lately a product under the name of antiphlogistin has been used locally with excellent results and its use is to be commended even in local wound inflammation. If the subcutaneous tissue is affected and the surface indicates the breaking down of tissue, hot antiseptic applications are advisable or the skin is incised down to the deep fascia at such places and iodoform gauze is packed into the wound for several hours. Constant antiseptic irrigation is then established by means of drainage tubes inserted into the various incised places, which are connected to an irrigating apparatus, so that the antiseptic may reach all parts of the infected area.