Diseases of the skin : their description, pathology, diagnosis, and treatment / by H. Radcliffe Crocker.

  • Crocker, H. Radcliffe (Henry Radcliffe), 1845-1909.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the skin : their description, pathology, diagnosis, and treatment / by H. Radcliffe Crocker. Source: Wellcome Collection.

    178/786 (page 142)
    when it affects the saphenous nerve, when there may be vesicles on the heel. Names have been given to designate herpes of these regions, and so authors speak of H. frontalis, ophthalmicus, cervicalis, brachialis, cruralis, genitalis, eervico-brachialis, intercosto-hume- ralis, genito-cruralis, and so forth. The only difference is in the positions, but of course the eruption groups are in lines, not in zones since they follow the nerve distribution. Herpes is very rarely symmetrical, and then it is said to be generally of syphilitic origin, and chiefly affects the fifth pair.* It may occasionally be bilateral, affecting nerves at a different level, and it is common for some of the vesicles to overstep the middle line, doubtless because a cutaneous nerve twig has extended farther than usual. Haemo- rrhage sometimes occurs into the vesicles, or the inflammation may be so intense as to be purulent from the first, and in rare instances the patches may ulcerate, or even become gangrenous. Scarring of course, then ensues. For some inexplicable reason, zoster, as a rule, does not attack the same person more than once in his lifetime, but there are exceptions ; one of the most notable was Kaposi's case.f Within a short space of time, there were five attacks in the right cervico-brachial region, later on a sixth attack in the right lumbo- sacro-crural region, whilst the seventh, eighth, and ninth outbreaks were in the left cervico-brachial region, and there have been two abortive attacks since. Tilbury Fox had a patient who had several attacks in the course of a few years, and always in the summer. Chronic peripheral irritation is the most usual cause of such repetitions. Thus I have seen recurrent herpes round the sinus produced by a diseased tooth. Pearse Gould had a similar case from caries of a rib, etc. Although the neuralgic pain usually subsides when the eruption is out, and may even be absent altogether, sometimes, owing to a chronic neuritis having been set up, the pain persists, and in old people, in whom it is specially liable to occur, becomes of serious moment from exhaustion, consequent upon the pain and loss of ^ In a few cases, persistent pruritus, hyperesthesia, or anaesthesia • A case of this kind is figured in Hebra's Alias, vol. ii., Lief vi., Tafel_ifl f Abstract from Wiener Med. Wochensehnft, 1874, i375- and 1877, m Mat. Rec, November 15th, 1877.