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.

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    scratcliing, then one sees, in the place formerly occupied by it, a stilly unhealed defect of the corium, on which a new crust has to form before healing can take place. It is clear that by such imprudent manipulation the time of the local recovery is still more delayed. Pio-nicntations of the skin almost invariably remain behind after decrustation as immediate results ; these have at first a distinctly hyper- emic color, and are for a certain time correspondingly sensitive to the influences of the external temperature. Later on, they lose this char- acter and become brownish in color, then gradually pale, and after some months entirely disappear. . These pigmentations, during their continu- ance, give to the smallpox convalescent a peculiar spotted appearance, which is especially marked in the face, but, as already noted, is not of long diu’ation. Many of these pigmented s])ots form at first flat eleva- tions (papules), this peculiarity being due generally to a remnant of the hyperemic swelling of the papillae ; these soon become level again, and, like the pigmentations, leave no permanent trace. Other pigmented areas lie at the level of the rest of the skin, hence are purely macular and usually leave no permanent mark. Still others correspond to shal- low depressions of the skin, which are related to a pressure atrophy of the papillae in these places. This simple atrophy of the papillae, caused by too long continuance of pressure from the purulent exudate resting u]ion them, is not capable of restoration ; yet the stigmata resulting from it, although permanent, are not especially disfiguring, and should be distinguished from the true smallpox scars. Finally, there are areas which are pigmented at first, but which become the permanent smallpox scars; these, therefore, are likewise at first hyperemic and dark-colored, but later assume a whitish color. While the surface of the body of the smallpox patient is becoming completely freed from the remains of the exanthem, and while the residual changes of the skin just described are developing, the general convalescence in uncomplicated cases of variola vera is in most instances making rapid headway. The whilom patient, after the miseries endured during the preceding weeks, experiences the increasingly pleasant sen- sations of happy recovery from severe illness, eats with avidity, increases ra])idly in weight, thus replacing what he had lost, and’finally tries to employ himself suitably again, physically as W'ell as mentally. In the former, he usually succeeds more quickly than in the latter. The hair of the head and beard and other places falls subsequently, and thus for a time reminds him of the horrors he has passed through ; but later there is complete restoration, if the hair-bulb has not undergone a de- structive process.