A system of surgery . ocal complications maybe mentioned a per-sistent oedema, which sometimes ensues, and produces permanentthickening or elephantiasis. When the sheaths of tendons have beenimplicated, limitations of movement in the fingers or toes may result,and ankylosis when the joints have been involved. When erysipelas attacks the organs of special sense, it may destroysight, or smell, or hearing, or greatly impair these functions. Muscular paralyses occasionally follow erysipelas, especially ofthe pharynx after erysipelas of the fauces (Todd). Many com-plications are caused by direct ex
A system of surgery . ocal complications maybe mentioned a per-sistent oedema, which sometimes ensues, and produces permanentthickening or elephantiasis. When the sheaths of tendons have beenimplicated, limitations of movement in the fingers or toes may result,and ankylosis when the joints have been involved. When erysipelas attacks the organs of special sense, it may destroysight, or smell, or hearing, or greatly impair these functions. Muscular paralyses occasionally follow erysipelas, especially ofthe pharynx after erysipelas of the fauces (Todd). Many com-plications are caused by direct extension from the original instance, in facial erysipelas the inflammation may spread tothe eye, conjunctiva, lachrymal apparatus, orbit, nose, pharynx, orlarynx, or to the lungs and air-passages. From the pharynx itsometimes extends along the Eustachian tube to the middle ear. Inthe air-passages it may cause a fatal oedema of the glottis. Perhapsthe parotiditis which sometimes complicates facial erysipelas is. Fig. 26.—Streptococci in the Hearts Blood from a Casewhich died of Stpticsemia after Erysipelas. (Prom amicrophotograph by Mr. Cosens.) 162 ERYSIPELAS. due to extension along Stensons duct. Erysipelas of the penis mayspread to the urethra and bladder. Erysipelas of the female genitals(erysipelas puerperale) may spread to the uterus, Fallopian tubes,and peritoneum. From wounds of the abdominal walls erysipelas may spread byextension to the peritoneum, ox*, after injuxies to the head, from thescalp to the meninges. The streptococcus of erysipelas may enter the blood in suchquaixtities as to cause fatal septicaemia. In a case of this kind Ifound the streptococcus in the blood of the right auricle (Fig. 26). Pyamxia is a frequent cause of death in erysipelas. It is morefx*equent in the cellulo-cutaneous and cellular vaxieties. It is dueto the entrance of pyogenic organisms, especially of streptococci,into the circulation, and their subsequent passage fx-om the circ
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