Study of 810 cases. A direct relation found between menstruation and ery sipelas in only 5.2 per cent. In 1.62 per cent. menstruation could be regarded as a direct etiological factor. In 57 cases of recurrent erysipelas only 3 were due to menstruation. Erysipelas has no ap preciable influence on the duration and amount of the flow. On the contrary, menstruation favors the development of erysipelas through its influence on the nervous system. Recurrences during the flow are due to the peculiar nervous state of the patient and to the persistence of colonies of streptococci in the skin and lymph-spaces, whose virulence has not been entirely destroyed. Salvy (Gaz. Hebdom. de Med. et de Chin, No. 40, '90).
In most instances spontaneous recur rent erysipelas of the face develops from the nasal foss through the lacrymal duct or the nostrils. The point of de parture is either in the nasal fossm or, more frequently, in the more or less hypertrophied adenoid tissue of the pharyngeal cavity. The preventive and also the curative treatment of recurrent erysipelas of the face consists in taking care of the nasal and naso-pharyngeal cavities, but especially in reducing the adenoid tissue in the pharyngeal vault, which the surgeon must remove even from between the Eustachian cushions.
H. Lavrand (Revue Hcbd. de Lar., d'Otol., et de Rhin., Sept. 5, '96).
In the production of facial erysipelas chronic nasal affections play an impor tant role; hence the frequency with which erysipelas starts from the centre of the face, the orifice of the nostril being a favorite point of departure. F. de Havilland Hall (Lancet, Feb. 6, '97).
In 100 cases a local abrasion accounted for the entrance of the organisms in the majority; in erysipelas of the face the nasal mucous membrane was very often found to be in an unhealthy condition, while in other cases the throat was evi dently the channel of infection. Allen (Med. News, Apr. 8, '09).
Certain attacks of erysipelas have proved a source of immunity against anthrax, at least for a few days. There is a growing opinion that it exercises a direct effect against the development of sarcoma. Indeed, cases are reported of sarcomatous growths having gradually disappeared after an attack of purulent erysipelas; hence the practice of inocu lating erysipelas in those suffering with inoperable sarcoma. This procedure is not, however, without danger to the pa tient, for it is not always possible to limit the development of the disease; hence the patient should be made cog nizant of the risk to be run by the inocu lation of erysipelas for the destruction of sarcoma.
Anthrax immunity lasts only so long as the erysipelas cocci remain in the body, and that after ten to fourteen days the susceptibility to anthrax poisoning is as great as before. A too powerful injection of erysipelas cocci may cause death as certainly as would the anthrax poison. I1attei (Bull. Gen. de Therap., Nov. 15, 'SS).
Cases summarized where erysipelas has been artificially excited to cure (1) five sarcomas: three cured, two re lapsed; (2) six doubtful cases (sarcoma or carcinoma) : failure; (3) three ulcer ative epitheliomas: failure; (4) two eieatricial keloids and "several" lympho mas: cure. Bruns (Centralb. f. Chin, p. 620, '88).
Case of a woman in whom ulcerous syphilides of the face were cured by an attack of erysipelas of the face. Lop (Marseille-med., Mar. 15, '92).
When a syphilitic exanthein is un accompanied by malignity or eachexia, a febrile erysipelas intervening is favor able. Ricard and Dupre, Lamarche, and ?Iauriac (These de Paris, '56) ; Lop (Marseille-med., Mar. 15, '02).
Case of advanced leprosy of the con junctiva which was much ameliorated by an attack of erysipelas, the leprous nodules disappearing entirely from the conjunctiva, but recurring six months later. Terson (Societe d'Ophtal. de Paris, Apr. 14, '96).
The danger to the patient from effect of erysipelas toxins upon malignant growths is great. The alleged successes are so few and doubtful in character that the most that can be fairly alleged for the treatment by toxins is that it may offer a very slight chance of amel ioration. Valuable time has often been lost in operable cases by postponing operation for the sake of giving the method of treatment a trial, and, if the method is to be resorted to at all, it should be confined to the absolutely in operable cases. L. A. Stimson, A. G. Gerster, and B. F. Curtis (Annals of Surgery, July, '96).
Erysipelas can bring about improve ment and even a lasting cure of lupus. One of the best chances of cure for a lupoid patient is to contract erysipelas. It may be advisable to practice inocula tions with it, when we shall be in posses sion of a method of treatment capable of checking its progress at the right time if it happens to assume a danger ous character. Hallopeau and G. Bureau (Bull. de la Soc. Franc. de Derm. et de Syph., June, '96).