ly for
several days, even although the erysipelas has not overstepped the ring.
Success depends upon using the liniment of iodine (the tincture is not
strong enough), and in applying it well in front of the disease. To
allay pain the most useful local applications are ichthyol ointment (1
in 6), or lead and opium fomentations.

The general treatment consists in attending to the emunctories, in
administrating quinine in small--two-grain--doses every four hours, or
salicylate of iron (2-5 gr. every three hours), and in giving plenty of
fluid nourishment. It is worthy of note that the anti-streptococcic
serum has proved of less value in the treatment of erysipelas than might
have been expected, probably because the serum is not made from the
proper strain of streptococcus.

It is not necessary to isolate cases of erysipelas, provided the usual
precautions against carrying infection from one patient to another are
rigidly carried out.

DIPHTHERIA

Diphtheria is an acute infective disease due to the action of a specific
bacterium, the _bacillus diphtheriae_ or _Klebs-Loffler bacillus_. The
disease is usually transmitted from one patient to another, but it may
be contracted from cats, fowls, or through the milk of infected cows.
Cases have occurred in which the surgeon has carried the infection from
one patient to another through neglect of antiseptic precautions. The
incubation period varies from two to seven days.

#Clinical Features.#--In _pharyngeal diphtheria_, on the first or
second day of the disease, redness and swelling of the mucous membrane
of the pharynx, tonsils, and palate are well marked, and small, circular
greenish or grey patches of false membrane, composed of necrosed
epithelium, fibrin, leucocytes, and red blood corpuscles, begin to
appear. These rapidly increase in area and thickness, till they coalesce
and form a complete covering to the parts. In the pharynx the false
membrane is less adherent to the surface than it is when the disease
affects the air-passages. The diphtheritic process may spread from the
pharynx to the nasal cavities, causing blocking of the nares, with a
profuse ichorous discharge from the nostrils, and sometimes severe
epistaxis. The infection may spread along the nasal duct to the
conjunctiva. The middle ear also may become involved by spread along the
auditory (Eustachian) tube.

The lymph glands behind the angle of the jaw enlarge and become tender,
and may suppurate fro