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.

    83/730 (page 73)
    by all imaginable kinds of nervous symptoms, especially by delirium. A frenzied state, in which the patient strikes, screams, leaves his bed, runs about, etc., belongs to this stage. If now, as is unfortunately very frequentlv the case, death occurs at the height of the general disease through the intensity of the toxemic process, then, as a rule, the fatal issue closes the terminal phenomena by acute ])aralysls of the vital functions. The patient, wlio was formerly gen- erally described as ex- cited, becomes comatose, no longer responds to treatment, and tracheal rales arc heard. The juilse becomes extremely frc(pient and scarcely percei)tible, and, like the respiration, finally inter- mittent. AVith relative fre- (piency the alreadv high 6.—variola contlnens (aeoonUug to Curschmanu). * * Death with hyperpyrexia oil the tenth day of the disease (four- tebnle temperature, es- teen-year-oid girl), peeially in variola con- fiuens, is raised with constant rapidity to excessive heights (42° C. and over), and the exitus letalis accordingly follows in many cases, with the symptoms of the terminal or antemortem hy])erpyrexia, already men- tioned under variola discreta. (Compare p. 63.) Tn this hyperpyrexial state, even where, as in A'ariola, it develops from a febrile condition, we are concerned, in all probability, not simply with a maximal fever or one which has become maximal, but with something else, something new, essentially different from the fever and, in these cases, added to the fever. And we vdll not be far wrong if we regard this immoderate and ominous increase of temperature at the time of the death agony as a sign of sudden and complete cessation of the functions of the mechanism which regulates the temperature, due to a rapidly advancing paralysis of the nerve-centers regulating this mechanism. In the rarer cases in which the patient afflicted with variola con- fluens survives the period of suppuration, the abatement of the local and general symptoms is generally considerably slower than in variola discreta. In the first place, the desiccation of the skin rash lasts a long time, because, under the large and coherent crusts in the region of con- Day of the Disease.