. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. e smaller blood-vessels situatedround the lymphatic vessels. In the upper armthere is macular and cord-like reddening due tolymphangitis. The axillary glands are much swollenand painful. Wounds caused by bites from animals or men tendto become severely infected. In this case, the swell-ing of the forearm was so extensive that a deepphlegmon was suspected. The symptoms quicklysubsided after suspension of the arm. In the placewhere the erysipelas was hemorrhagic and bullous,there occurr
. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. e smaller blood-vessels situatedround the lymphatic vessels. In the upper armthere is macular and cord-like reddening due tolymphangitis. The axillary glands are much swollenand painful. Wounds caused by bites from animals or men tendto become severely infected. In this case, the swell-ing of the forearm was so extensive that a deepphlegmon was suspected. The symptoms quicklysubsided after suspension of the arm. In the placewhere the erysipelas was hemorrhagic and bullous,there occurred a superficial phlegmonous inflamma-tion, which led to gangrene of the skin. Differential Diagnosis. This has to be madefrom several other affections. Anthrax also com-mences with redness of the skin and the formation ofvesicles (Fig. 112), fever and rigors, and may, in itsearly stage, be confounded with this form of erysipe-las. But the redness is not so extensive in anthrax,nor so rapidly developed. Anthrax always causesearly gangrene of the skin. In doubtful cases 308 Bockenheimer, Atlas. Tab. hig. 91. Erysipelas biillosum iiaiiioiThagiciim. anthrax bacilli must be looked for in the contents ofthe vesicles. In this case, which arose from a horse bite, therewas a suspicion of glanders. But, in the latter theredness is punctiform or macular; the vesicles arelarger and purulent, and soon rupture, giving rise togangrenous ulcers. Subcutaneous phlegmons, which arise from veryvirulent streptococci, may cause an erysipelatousredness of the skin, but this only occurs in the regionof the phlegmon, and does not extend so rapidly aserysipelas. Vesicles may also form on the skin invirulent streptococcal infection. Phlegmons due to gas-forming bacteria ( malig-nant oedema. Fig. 109) cause rapid redness and swell-ing of a whole limb. Increase of pressure in thetissues from the formation of gas also gives rise tothe formation of vesicles, but these are very largeand often rai
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