Lectures on clinical medicine / [John Hughes Bennett].

  • Bennett, John Hughes, 1812-1875.
Date:
1850-1856]
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on clinical medicine / [John Hughes Bennett]. Source: Wellcome Collection.

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    FA YUS. Case I.1—Isabella Fergusson, jet. 22, a somewhat stout servant girl, with fair skin, and scrofulous aspect, was admitted into the clinical ward of the Royal Infirmary, May 6, 1849. She states that there has been an eruption on her head for the last twelve years. Four months ago the catamenia ceased, since which time she has been subject to occasional headach, constipation, and slight dyspepsia. Nearly the whole of the scalp is covered with a thick yel¬ low friable crust, of uneven surface, and irregular margin, emitting a highly offensive odour, like cat’s urine, and causing great itching and irritation. Up to the middle of July she was treated with various internal remedies, which subdued the constipation and dyspepsia, and caused return of the catamenia. The crusts on the scalp were removed by poultices, and an ointment, com- posed of ammon. mur. 3j.; and ung. sulphur is ^ §j., applied locally. I first took charge of the case on the 14th of June. The head was then again covered with favus crusts, some isolated, others compressed together, and forming an ele¬ vated scab. A small portion, examined under the microscope, presented the branches and sporules of the cryptogamic plant, so characteristic of the disease. The crusts were again removed by poultices of linseed meal, the head shaved, and cod-liver oil ordered to be applied to the scalp morning and evening,—the whole to be covered with an oil-silk cap. This treatment was continued for six weeks, but on suspending it the favus crusts returned. During the months of August and September iodine and pitch ointments were applied; portions of the scalp were even blistered, but without effect. At the commencement of October, the scalp being at the time perfectly clean and closely shaved, all local treatment was suspended, and the reappearance of the disease carefully watched. In three days the entire surface presented a scaly eiuption, the epidermis being raised, cracked, and broken up over the whole scalp, which was exceedingly dry and harsh. The furfuraceous condi¬ tion of the scalp continued, becoming more and more dense, until the four¬ teenth clay, when there were first perceived minute bright sulphur-coloured spots in it. These, on being examined microscopically, were seen to be com¬ posed of fine molecular matter mingled with epidermic scales, from which deli¬ cate blanched tubes were apparently growing. The crusts were now once more removed by repeated poulticing, and cod-liver oil applied as formerly.