. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. -tures may be very similar, and the diagnosis shouldalways be established by bacteriological diagnosis is all the more important to estab-lish, as the treatment differs in the different erysipelas, anthrax and glanders conservativetreatment is indicated, while streptococcal phlegmonrequires early incision to prevent general infectionand in gas-phlegmon very extensive incisions, or evenearly amputation of the limb, may be necessary tosave the patients
. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. -tures may be very similar, and the diagnosis shouldalways be established by bacteriological diagnosis is all the more important to estab-lish, as the treatment differs in the different erysipelas, anthrax and glanders conservativetreatment is indicated, while streptococcal phlegmonrequires early incision to prevent general infectionand in gas-phlegmon very extensive incisions, or evenearly amputation of the limb, may be necessary tosave the patients life. In Fig. 91 streptococci were found in the vesicles,and from this, together with the clinical symptomsthe diagnosis was made of hemorrhagic bullouserysipelas; but the possibility of a deep phlegmon 209 due to the bite still remained. However, the mild-ness of the constitutional disturbance, and the rapiddisappearance of the swelling showed it to be a caseof erysipelas only. Recovery took place in the courseof three weeks, with cicatrization of the gangrenouspart. 210 Bockenheimer, Atlas. Tab. Vlli. 92. Iirysipcloid. Rfbnian CoiiiDaiiy, New-York. ERYSIPELOIDPlate LXXIII, Fig. 92. An affection very similar to erysipelas, calledchronic erysipelas by Rosenbarh, is now known bythe term erysipeloid. This is also a bacterial infec-tion of the skin (according to Tavel, also of tendon-sheaths and joint capsules) but of a very harmlessnature. The specific cause of erysipeloid is unknown;in some cases the staphylococcus albus has beenfound. The affection begins with redness and swelling ofthe fingers. Like erysipelas, the redness has sharp,irregular borders. The redness spreads slowly butcontinuously over the whole finger, and may extendto the next finger and as far as the wrist. At thispoint the inflammation stops. There are no consti-tutional symptoms; no fever nor rigors. The pa-tients only complain of itching and a feeling of ten-sion in the skin. In some cases there is
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