MEDICAL NOTES.

New Zealand Herald, Volume XXX, Issue 9193, 6 May 1893, Page 1 (Supplement)

MEDICAL NOTES.

ERYSIPELAS AND ITS TREATMENT. • . [BY DR. ANDREW WILSON.] A curious and, at the same time, interesting form of disease is that which is known as erysipelas, and in certain parts of the country popularly as "rose." It gets the latter name from the reddened appearance presented by the part of the body it attacks. Erysipelas is common after some injury which is attended by wounding. For example, a man gets a simple cub on the head, which, properly cleansed and dressed, might heal without trouble. If, however, he is exposed to cold, and if his constitution iB not what it should be, if his system is low, and, above'all, if he is a drunkard, and has weakened his body by over-indulgence in alcohol, -the simple wound does nob heal readily. It exhibits, on the contrary, a decided tendency not to heal. It gets bluish round the edges, and begins to suppurate, and then, later on, the head and face begin to be attacked by redness and swelling, and the skin gets hard. The man's temperature rises, and a certain amo nt of fever ensues. This is erysipelas, which may either disappear under treatment, or may go on from bad to worse, and end in blood-poisoning and death. We see, therefore, first of all, how important it is to be very careful of even slight injuries, because, whenever we gob a break of skinespecially in an enfeebled bodywe may find that simple injury to prove the beginning of much more serious trouble. Of course, erysipelas may arise. from other causes than wounds and injuries. Exposure to cold is a comman cause of the trouble. Then, again, erysipelas may appear in the course of other ailments. It ie known sometimes to occur in gouty people, for example. A certain, amount of fever attends erysipelas, and, moreover, the disease seems to show a period _ during which it is coming to a head, as ib were. This would seem to point to some likeness between erysipelas and ordinary fevers, and, more than this, ib would entitle us bo believo that the cause of the trouble resides in some germ or other which the patient swallows, breathes in, or gets in a wound where such injury exists. The heat of the ; skin which is affected may be very great, so that the disease would seem bo have its outcome in the skin, where, aa_ we have seen, the redness and inflammation (great heat being one of the symptoms of inflammation) are found. • The treatment of this common trouble is not complicated, and home-nursing and care j do much to relieve the patient, and to pre- ] ' vent the development of serious symptoms. First and foremost, it is necessary to keep the patient away from all risk of chills and colds. The parts must be covered, say, with cotton wool, and the patient, in his bed, shielded from draughts. The inflamed skin must be dusted with some powder. A common plan is to use a flour-dredge, and to dust the flour on the skin. Physicians to-day often employ, instead of flour, a mixture of starch in fine powder and oxide of zinc, such as any chemist will readily make. A formula for such a powder is : Oxide of j zinc, one ounce; powdered sbarch, two ounces ; and powdered camphor, one drachm. Others advocate the use of oollodion and oil by way of protecting the skin, and the ailmenb has been also treated, in so far as the skin is concerned, by painting tincture of iodine or nitrate of silver on it—that is, lunar caustic —but this lash is a matter for the doctor, of course. One very common point) was long ago discovered regarding erysipelas—namely, that if, say, on the leg when the disease appeared, aline was drawn by nitraue of silver round the limb, the disease was limited by this line of caustic, and did not pass beyond it. Perhaps the destruction of the upper layer of the skin by the caustic acts as f barrier bo the spread of the erysipelas ; anyhow, this is a familiar practice which it is well to bear in mind. Passing to the general treatment of the , ailment, ib, is necessary, of course, to support the patient's strength. The good old rule " move the bowels" is of great value hero. There is one remedy which is of universal use in erysipelas, and that is iron. . The best form in which this can be given is that of the tincture of the perchloride of iron, or " steel drops" ; and in orysipaias, from twenty-five to thirtyfive or forty minims (or drops) should be given in water every three or four hours, during the active and feverish stage of the ailment. When the patient is recovering the doses need not bo so large ; _ fifteen to twenty minims (or drops) three times a day being then sufficient. It has been a recognised practice for physicans to give tincture of aconite in five minim doses every four hours in erysipelas which arises from an outsido cause, such as a wound; but this remedy is safest in medical hands. The rest of the treatment is simply a matter of keeping up the patient's strength on his way to health by giving him tonics—of which, as everybody knows, there is an immense selection. Quinine and iron, for instance, or compound tincture of cinchona, and the like, are suitable tonics.

HEALTHY LIVES. Fifty per cenb. of tho men and women (writes Dr. Gordon-Stables) whom one meets every day in the streets of a great city have no more real notion of what healbh leois like than a blind man has of the colours in the rainbow. Seventy per cent, -of the people we meet might effect such a revolution in the state of their health by six weeks' or two months' obedience to ordinary hygeinic rules, that they would i hardly know themselves at the end of that time. They would fool 10 per cent, younger and cent, per cent, happier. Abstinence in diet and sleeping in welltinted rooms would effeeb this improvement in most of them. Nearly all men and -especially women eat to much. The blood is, therefore, never 80 cold as ib oughbbo be, the mind and nerves never so calm. Men take stimulants to bring them up to par, or with an erroneous impression that they are thus increasing the powers of digestion, and they attempt to tone down the fever of the blood and brain by smoking. Then there is nob one bedroom in a hundred properly and scientifically ventilated. This is notoriously true. The bugbear cold has much to account for. To avoid this bugbear men and women sleep in rooms that are positively poisonous, breathing the same polluted air over and over again. Wo wonder they awake in tho morning from fevered dreams, feeling more jaded and weary than when they lay down. Bub bedrooms can easily be rendered sweeb and pure without courting the danger, of sleeping in a draught. What mora simple plan of ventilation, for instance, than establishing communication with the external air by means of perforated zinc in doors and windows. What a saving in doctors' bills this would lead to in every large family I The subject of " Healthy Lives" appeals to us individually and as a nation, though as far as the nation goes, I fear patriotism in England, south the Tweed ab all events, is about as rare as white starlings.

With very rare exceptions (says an American paper) the so-called aristocratic marriages between American women and Englishmen turn out very badly. That some Englishmen do nob marry to get hold of money bo squander is probably true ; bub thab mosb marriages between the people of the two countries are purely a matter of money the statistics of the lasb half-century prove. Possibly, there are Englishmen who do nob beab their wives; bub there is no Englishman who does nob claim the righb to do it. For, in spite of very fine manners and in some r. cases mosb winning graces, the Englishman, in anger, re' imes the traits of the race he declares so much pride in springing from—the Teutonic—whose wives were in early times mere slaves. Bub, in spite of examples, m spite of universal testimony, our sisters and daughtors will continue to fling themselves ab the heads of bhe sneering fortune-hunters and scarcely disguised profligates, who negotiate marriages with the rich simply to give them the means to live as lords must live abroad. An audacious acb of sacrilege, has been committed ab« the Rederaptorisb church in Vienna, where a seb of jewels, valued at 2000 florins, has been stolen from a picture of bhe Madonna. The jewels were an offering made by the- Archduchess Maria Theresia, wife of the Wurtemberg heirapparent, after her pilgrimage to Treves, as j a thanksgiving for her recovery from typhoidiemv