Selected essays and monographs : translations and reprints from various sources.

Date:
1897
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Licence: Public Domain Mark

Credit: Selected essays and monographs : translations and reprints from various sources. Source: Wellcome Collection.

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    occur directly as a result of hemorrhage from the mucous membranes. Cardiac complications were not present in my cases; the murmur in one case quickly disappeared. Endocarditis is rare, having occurred in only two cases in the total series. Pericarditis occurred in three cases. This is a much smaller percentage of heart complications than in the cases of erythema nodosum collected by Stephen Mackenzie. I have only once seen cardiac complications in peliosis rheumatica. The case has been reported by Dr. Musser,* who very kindly took me one day to see the case. The patient had extensive peliosis rheumatica with pericarditis and a gangrenous slough on the uvula. The respiratory organs are less frequently involved. In Case II. the recurring attacks of cough with bronchitis are, I believe, part of the affection. The sputa always indicated bronchitis, and at times the cells of the alveolar epithelium have been unusually abundant. The cough was often dry, very annoying and persistent, and there was once or twice sneezing. In v. Dusch and Hoche’s list of thirty-nine cases pleurisy is mentioned twice, bronchitis once, and pneumonia twice, both fatal cases. In Case IX. of my series pneumonia followed the disease and proved fatal. In this connection it is interesting to note the statement of Lewin, who found among seventy cases of erythema nodosum in the literature four deaths from pneumonia. The onset of the attack may be with a chill, as in Case X.; more frequently the skin lesions are preceded by feelings of indisposition and slight gastric disturbance. The curious prodrome, which has recurred during so many years in Case I., great coldness of the feet, I have not seen mentioned. Fever is a frequent accompaniment of the attack. In cases which have the type of peliosis rheumatica the temperature may range from 101° to 103°, or even higher, for several days; there may, however, be the most extensive skin lesion without pyrexia. At the height of the attack delirium may occur. Perhaps the most extraordinary and distressing feature of the disease is the tendency to recur, which is so noticeable in all types of exudative erythema. In Case XI., in which the disease has persisted for four years, during the first two years the girl * Transactions of the Association of American Physicians, vol. vi., p. 284.