Variola, vaccination, varicella, cholera, erysipelas, whooping cough, hay fever / by H. Immermann [and others] ; edited with additions by John W. Moore ; authorized translation from the German, under the editorial supervision of Alfred Stengel.

  • Immermann, H.
Date:
1902
Catalogue details

Licence: In copyright

Credit: Variola, vaccination, varicella, cholera, erysipelas, whooping cough, hay fever / by H. Immermann [and others] ; edited with additions by John W. Moore ; authorized translation from the German, under the editorial supervision of Alfred Stengel. Source: Wellcome Collection.

    514/730 (page 500)
    first five days of the disease symmetrically situated, actively reddened, and tensely swollen areas, which were difficult to differentiate from an erysipelas, because the swollen areas were sharply outlined from the surrounding dotted region. Such eruptions occurred successively upon the cheeks, arms, and legs, and were accompanied by continuous fever. (Appropriate culture-media were inoculated with the blood, but they remained sterile.) An actual erysipelas occurring with scarlatina, such as we have described on page 494, was excluded chiefly because the rapidly ad- vancing cutaneous swellings were observed simultaneously upon the face, arms, and legs, and there was no demonstrable connection be- tween these large areas of cutaneous redness. It is therefore most likely that an exudative erythema was present in addition to the scar- latina. On the other hand, it is also possible that it was only a severe case of scarlet fever in which the toxins not only produced a con- tinued fever and prostration for almost sixteen days, but also the peculiar violent hritation of the skin. The differentiation from zoonotic erysipeloid is of practical im- portance. This exanthem, first described by F. J. Rosenbach,^® and wliich will be specially considered at the close of this monograph, may actually be confounded with true erysipelas. This error will be always avoided if the description of the disease is carefully considered. In all afebrile exanthemata of the face which extend over one or both cheeks, —generally like the wings of a butterfly,—the first thought should be of erysipeloid. I do not doubt that this affection has frequently given rise to the supposition of an afebrile erysipelas. I have several times had the opportunity of correcting such diagnoses, and consequently recommend attention to this point. The diagnosis of erysipelas of the mucous membranes is much more difficult. With rare exceptions (see Laryngeal Erysipelas, p. 466) it is to be certainly diagnosticated only when preceded or followed by a cuta- neous erysipelas. Redness and swelling are by no means character- istic; the concomitant phenomena—^glandular swelling, fever, albu- minuria, swelling of the spleen—may appear in any active inflamma- tion of the throat. It is always well to think of erysipelas, however, in those cases of sore throat which commence acutely with a chill, and proceed with active redness, swelling, painful enlargements of the lym- phatic glands, and marked constitutional symptoms. [In the editor’s experience, the erysipelatous sore throat is remarkable for the intense pain which accompanies it.] We will take this opportunity to also consider those very malignant