For erysipelas of the face and scalp ichthyol and vaselin, equal parts, form an excellent local application, placing over this absorbent cotton.
The affected parts should be painted morning and evening with collodion, to which ichthyol has been added in the strength of 10 per cent., the application being made so as to cover the healthy skin for an extent of three centimetres around the affected patch; the applica tion is always made from healthy to dis eased skin. In eighty cases in which the author has used this method it has not failed once. When the varnish comes away the skin is left in a healthy con dition. No bad effects of the treatment have been observed. Victor Cebrian (El Siglo Medico, Dee. 17, '93).
Hypodermic injections of pilocarpine recommended in facial erysipelas. The drug must be administered until the physiological effects are produced. Pilo carpine is contra-indicated in affections of the heart. If the erysipelas appear as a complication, the treatment is absolutely without efficacy. Salinger (Therap. Gaz., Mar. 15, '94).
Thirty-two cases of erysipelas of the face and other parts of the body treated with compresses saturated in absolute alcohol, with excellent results. To pre vent evaporation the compresses must be covered with some impermeable ma terial and should be changed every fifteen minutes, until all inflammation has subsided, two or three days being generally required. Langsdorff (La Sem. Med., Feb. 27, '95).
Erysipelas can be aborted by means of ichthyol: Ichthyol 2 drachms; flex ible collodion, 1 V, ounces, is applied every three hours, always commencing the application about one inch beyond the line of demarkation between the healthy and inflamed skin. The latter is an important feature of the treatment. W. H. Delrett (St. Louis Med. and Surg. Jour., Aug., '95).
Todol excellent as an abortive of facial erysipelas, as proved in 25 eases. The remedy dissolved in collodion and the 10-per-cent. solution painted over the affected part in thick layer extending a few centimetres beyond the limits of the erysipelas. Rapid cure effected in all cases. Lobit (Bull. G6n. de Therap., vol. exxxv, p. 540, TS).
In sthenie cases of erysipelas, in which the depressing effects of the drug are not to be feared, pilocarpine acts with almost specific utility. Injected beneath the skin once or twice daily in doses of grain, or given by the mouth in doses of from to V. grain thrice daily, it seems capable of bringing the disease to favor able termination within from twenty four to seventy-two hours. A. A. Eshner (Jour. Med. and Surg., Apr., '99).
Eight cases treated with mercurial ointment. It is efficacious against facial
erysipelas even when tending to spread. Its value depends not only upon its bac tericidal properties, but as well because it can penetrate the skin and reach the streptococci in the subcutaneous tissue. Prospero Dematteis (Gaz. degli Osped. e delle Clin., No. HS, '99).
Sulphate of sodium is very effective as a local application, owing to the affinity which sulphate of sodium has for oxygen: abstracting it so rapidly from the diseased area as to soon de stroy the germ of erysipelas. The area is first thoroughly cleansed, removing all greasy substances. Enough sodium sulphate being mixed with cold distilled water to give it the consistency of a thick poultice, the diseased part is cov ered with a single layer of gauze, and over this is spread a thick layer of so dium sulphate, care being taken that it extends considerably beyond the margin of the diseased area. The poultice is kept in place by a few layers of gauze. Ice-water is now applied to the poultice. G. L. Curtis (Med. Record, Apr. 20, 1901).
Ichthyol has been personally em ployed in the treatment of erysipelas with great success. The affected region and the adjacent area of the healthy skin are covered with a thick layer of ichthyol. It is seldom necessary to re peat the application on the third day. Usually the disease comes to a stand still. and desquamation follows inside of a week. Eschle (Heilkunde, No. 6, 1901).
Eighteen cases treated with red light rays,—i.e., by excluding the chemical rays. The fever ceased in less than one clay in 7; in one day in 1 case; in two clays or less in 4 cases; in two and one half days in 3 cases; in six days in 1 case, and in seven days in 1 case. Only 1 of the patients had any general symp toms, and he complained of headache. The red rays have no curative effect, but they are the only rays that are not directly injurious. H. Krukenburg (Milnchener med. Wochen., April 1, 1902).
Illieter has recommended the par enchymatous injection of 2- or 3-per cent. solution of carbolic acid at the mar gin of the inflamed district, particularly in the beginning of erysipelas. In cellulo cutaneous erysipelas and cellulitis a series of incisions, each about two inches long, should be made in the inflamed cellulose tissue in order to prevent gan grene and give exit to the pus or dis charges. These incisions are made where the skin seems to be most in flamed, in the direction of the long ac cess of the limb, parallel with the blood vessels, so that these should not be wounded. It may be necessary to give an anaesthetic to make these incisions.