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ERYSIPELAS.
497
thickened and contracted, had formed the stricture. Above the sound part, the ulturned without faeculent matter, but there ceration had extended upwards, for at least was some blood with it; th man was fur- four inches, and in this portion there was ther directed to take an ounce of castor oil. an ulcerated opening in the fore part of the
draught was
enema was
now repeated, and a common injected, which, however, re-
When Mr. Jeffreys saw the patient, about bowel, extending through the peritoneal noon, the spasm of the abdominal muscles covering into the cavity, of the pelvis. At had abated, but the tenderness of the abdo- the sphincter ani there was another ulcerated men had increased, and the countenance was opening, leading to a cavity, of the size of becoming anxious ; he brought up the cas- an egg, between the rectum and bladder. tor oil soon after taking it. Mr. Jeffreys Neither faeces nor blood were detected ia now directed him to take camphor and calo- the abdominal cavity. mel, of each five grains, with two grains of opium, in two pills, immediately ; and also OPERATIONS. to take three table spoonsful of the followOn Thursday, the 22d ult. Mr. Keate ing mixture every four hours : one ounce of performed the operation of lithotomy on a of one and drachm a sulphate magnesia, five of age. The external inciboy years half of compound spirit of sulphuric aether, and eight ounces of camphor mixture.-- sion was made by the scalpel, and the bladder cut into with the bistozlri cach’ee. The During the afternoon another clyster was calculus, which was of a moderate size, was administered, which brought away no fasces: and the boy has done towards midnight the pulse became quick readily extracted, On same day, Mr. Brodie rewell. the and fluttering, the countenance sunk and moved some portions of necrosed bone anxious, and the vomiting still continued. from the tibia of a little girl, and Mr. Rose 5. Has had a restless night; the pain is removed the metatarsal bone of the great toe. severe. leeches Twelve were apstill very plied to the abdomen last night, and he has been put into a warm-bath this morning, ERYSIPELAS. without any relief. Some blood has passed per anum, but nothing like faeces have To the Editor of THE LANCET. passed. The vomiting still continnes, and a brown fluid, of a thick consistence, is SIR,—The subject of erysipelas having of ejected. The pulse is quick, 112, weak, late much occupied the pages of your valuand scarcely perceptible ; the abdomen is able publication, and as I acknowledge mytense, distended, and exquisitely tender on self an advocate for sparing the patient, pressure ; the patient has not evacuated any (when it can be done consistently with urine since yesterday morning ; he feels a safety) the pain necessarily attendant upon desire, but has not the power. Mr. Jeffreys incisions made in exquisitely tender and attempted to pass the catheter, for a consi- inflamed parts : 1 have taken the liberty of derable time. but failed. sending you the following case, to which you 2 o’clock, p. M. The countenance is sunk, will oblige me by giving publicity. and of a leaden hue ; the finger nails are Mary Wensley, a woman of a full healthy livid, and the feet are cold ; the whole body habit, was seized, without any assignable is bedewed with the cold damp sweat, pre- cause, with active erysipelatous inflammacursory to death. About five o’clock hiccup tion, (erysipelas occupying the came on; he then sunk rapidly, and died at whole of the leg, attended with the usual seven, P. 111. symptoms of irritative fever; in visiting her, the limb was directed to be enveloped Post Mortem Examination. in a large linseed meal poultice, powerful The abdomen having been laid open, the aperient medicines were administered, and peritoneum, covering the intestine, was the antiphlogistic system in every respect found to have been in a high state of rigidly insisted on; notwithstandin this, flammation; a large quantity of purulent the erythema continued to extend itself fluid was discovered, partly in the abdomi- until the entire thigh and leg were involved nal and partly in the pelvic cavity. The in one continuous inflammatory action ; the bladder and rectum, with the sphincter ani, same treatment was persisted in, with the ocwere now removed from the body. On casional use of a spirituous lotion; and almaking an incision into the rectum, at its though at one period the constitutional back part, a very extensive ulceration of its symptons became exceedingly alarming, the mucous membranes was brought into view. diseased action gradually subsided, and the The ulceration commencing at the anus, oc- patient is now in a fair way of recovery. cupied the whole circumference of the gut, Bristol, Dec. 12th, 1827. 1. EARLE. I. EARLE. for about two inches ; above this, was a Mr. Earle partakes of the common error; circle of sound membrane, to about, the same extent, the lower edge of which being this was not a case for incisions.—ED. L.
vesiculosum)
in-
thickened and contracted, had formed the stricture. Above the sound part, the ulturned without faeculent matter, but there ceration had extended upwards, for at least was some blood with it; th man was fur- four inches, and in this portion there was ther directed to take an ounce of castor oil. an ulcerated opening in the fore part of the
draught was
enema was
now repeated, and a common injected, which, however, re-
When Mr. Jeffreys saw the patient, about bowel, extending through the peritoneal noon, the spasm of the abdominal muscles covering into the cavity, of the pelvis. At had abated, but the tenderness of the abdo- the sphincter ani there was another ulcerated men had increased, and the countenance was opening, leading to a cavity, of the size of becoming anxious ; he brought up the cas- an egg, between the rectum and bladder. tor oil soon after taking it. Mr. Jeffreys Neither faeces nor blood were detected ia now directed him to take camphor and calo- the abdominal cavity. mel, of each five grains, with two grains of opium, in two pills, immediately ; and also OPERATIONS. to take three table spoonsful of the followOn Thursday, the 22d ult. Mr. Keate ing mixture every four hours : one ounce of performed the operation of lithotomy on a of one and drachm a sulphate magnesia, five of age. The external inciboy years half of compound spirit of sulphuric aether, and eight ounces of camphor mixture.-- sion was made by the scalpel, and the bladder cut into with the bistozlri cach’ee. The During the afternoon another clyster was calculus, which was of a moderate size, was administered, which brought away no fasces: and the boy has done towards midnight the pulse became quick readily extracted, On same day, Mr. Brodie rewell. the and fluttering, the countenance sunk and moved some portions of necrosed bone anxious, and the vomiting still continued. from the tibia of a little girl, and Mr. Rose 5. Has had a restless night; the pain is removed the metatarsal bone of the great toe. severe. leeches Twelve were apstill very plied to the abdomen last night, and he has been put into a warm-bath this morning, ERYSIPELAS. without any relief. Some blood has passed per anum, but nothing like faeces have To the Editor of THE LANCET. passed. The vomiting still continnes, and a brown fluid, of a thick consistence, is SIR,—The subject of erysipelas having of ejected. The pulse is quick, 112, weak, late much occupied the pages of your valuand scarcely perceptible ; the abdomen is able publication, and as I acknowledge mytense, distended, and exquisitely tender on self an advocate for sparing the patient, pressure ; the patient has not evacuated any (when it can be done consistently with urine since yesterday morning ; he feels a safety) the pain necessarily attendant upon desire, but has not the power. Mr. Jeffreys incisions made in exquisitely tender and attempted to pass the catheter, for a consi- inflamed parts : 1 have taken the liberty of derable time. but failed. sending you the following case, to which you 2 o’clock, p. M. The countenance is sunk, will oblige me by giving publicity. and of a leaden hue ; the finger nails are Mary Wensley, a woman of a full healthy livid, and the feet are cold ; the whole body habit, was seized, without any assignable is bedewed with the cold damp sweat, pre- cause, with active erysipelatous inflammacursory to death. About five o’clock hiccup tion, (erysipelas occupying the came on; he then sunk rapidly, and died at whole of the leg, attended with the usual seven, P. 111. symptoms of irritative fever; in visiting her, the limb was directed to be enveloped Post Mortem Examination. in a large linseed meal poultice, powerful The abdomen having been laid open, the aperient medicines were administered, and peritoneum, covering the intestine, was the antiphlogistic system in every respect found to have been in a high state of rigidly insisted on; notwithstandin this, flammation; a large quantity of purulent the erythema continued to extend itself fluid was discovered, partly in the abdomi- until the entire thigh and leg were involved nal and partly in the pelvic cavity. The in one continuous inflammatory action ; the bladder and rectum, with the sphincter ani, same treatment was persisted in, with the ocwere now removed from the body. On casional use of a spirituous lotion; and almaking an incision into the rectum, at its though at one period the constitutional back part, a very extensive ulceration of its symptons became exceedingly alarming, the mucous membranes was brought into view. diseased action gradually subsided, and the The ulceration commencing at the anus, oc- patient is now in a fair way of recovery. cupied the whole circumference of the gut, Bristol, Dec. 12th, 1827. 1. EARLE. I. EARLE. for about two inches ; above this, was a Mr. Earle partakes of the common error; circle of sound membrane, to about, the same extent, the lower edge of which being this was not a case for incisions.—ED. L.
vesiculosum)
in-