Erysipelas Migrans.



Having read a good deal of late about erysipelas, in the different medical journals, and noticing with considerable interest the successes and failures of my confreres, I thought I would contribute a report of a case of erysipelas migrans that I lately have had.

I was called to see a young man, thirty-four years of age, tailor by trade, whose face and neck were badly inflamed and swollen, showing a typical erysipelatous condition, which had spread around his neck and shoulders.

He had tried two doctors before he called me in. His pulse was 140 and his temperature 105.5°F. lt was certainly a bad case—the worst I have ever seen of this disease. I gave him the following prescription:

Specific aconite minims 6
Specific belladonna minims 6
Specific echinacea drams 6
Cascara evacuant drams 1 ½
Elixir simplex q. s. ounces 4

Mix. Sig: Teaspoonful every two hours.

On the face I applied a wet dressing of a saturated solution of boracic acid. I soon got his systemic symptoms under control, but the erysipelas kept spreading. I applied various solutions, among others, a strong solution of permanganate of potash, also the tincture of chlorid of iron, but nothing seemed to do any good.

The face got better, but the erysipelas spread down to the nipple in front and to the angle of the scapula on the back. At last I mixed equal parts of the tincture of chlorid of iron and the tincture of iodin, and painted this with a camel's hair brush. This worked well and I soon got the disease under control.

At first I painted it on just about one-eighth or one-fourth of an inch beyond the margin of the inflammation, but this was not enough and radiation extended from the margin at various points. Then I painted it on a full inch beyond the margin. This stopped the spreading effectually.

A peculiar feature of this case was, that while the disease kept spreading, the earlier inflammation healed up and the skin peeled off, leaving a healthy surface underneath. At one time during the progress of the disease, the glands in the axillae and those of the neck began to swell. The addition of phytolacca to the treatment corrected that complication.

On the third day the pulse was 100 and the temperature was down to 102.5°F. From that time on the temperature gradually decreased until the ninth day of my treatment, when it became normal, and the day afterward it was subnormal-was down to 97°.

On the twelfth day I discharged him cured, and both the patient and myself were well satisfied with the outcome.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.