let, but which changes to a deep purplish tint. There is a
slight elevation of the skin, sometimes accompanied by itching. In the
second stage of development, the flush subsides, the skin has a
yellowish or bruised appearance, and a few minute scales are formed. In
_erythema papulosum_, a fine representation of which is given in Colored
Plate III, Fig. 18, there is an eruption of red pimples or pustules. The
prominent feature of _erythema nodosum_, a variety of erythema which
affects those portions of the skin exposed to the sun, is the appearance
of a large swelling, usually lasting four or five days and attended by
constitutional symptoms, such as nausea, fever, languor, and
despondency. The disease is associated with the symptoms incident to a
disordered nervous system and sometimes results fatally, in other cases,
it terminates in melancholy and mania.

CAUSES. The predisposing causes of erythema are constitutional debility,
changes of climate and temperature, and irritating food or medicines.
Locally, it may be produced by friction and the heat of the sun.

[Illustration: Plate III.
Fig. 14.
Fig. 15.
Fig. 16.
Fig. 20.
Fig. 17.
Fig. 19.
Fig. 18.]

ERYSIPELAS. There are few adult persons in this country who have not, by
observation or experience, become somewhat familiar with this disease.
Its manifestations are both constitutional and local, and their
intensity varies exceedingly in different cases. The constitutional
symptoms are usually the first to appear, and are of a febrile
character. A distinct chill, attended by nausea and general derangement
of the stomach is experienced, followed by febrile symptoms more or less
severe. There are wandering pains in the body and sometimes a passive
delirium exists. Simultaneously with these symptoms the local
manifestations of the disease appear. A red spot develops on the face
the ear, or other part of the person. Its boundary is clearly marked and
the affected portion slightly raised above the surrounding surface. It
is characterized by a burning pain and is very sensitive to the touch.
It is not necessary for the information of the general reader that we
should draw a distinction between the different varieties of this
malady. The distinctions made are founded chiefly upon the _depth_ to
which the morbid condition extends, and not on any difference in the
_nature of the affection_.

Suppuration of the tissues involved is common in the severer forms.
Should the