A course of clinical lectures on diphtheria : delivered before the class of Hahnemann Medical College, Chicago, session of 1862-3.

  • Ludlam, R. (Reuben), 1831-1899
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: A course of clinical lectures on diphtheria : delivered before the class of Hahnemann Medical College, Chicago, session of 1862-3. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    accompanied throughout its course by febrile symptoms, than is the diphtheria maligna. The height of the fever, however, does not appear proportional to the severity of the attack. Some of the mildest examples of this disease are characterized by the most violent febrile paroxysms, while the opposite is true of those cases which, from the outset, are more decidedly virulent in their nature. Its type is nearly always remittent, although it may sometimes, and in certain localities will be- come either continued, or indeed intermittent. The paroxysm usually recurs at evening, and is marked by a hot, dry skin, with burning of the hands and feet for the relief of which the little patient, if old enough, desires to be sponged off with warm water. In some cases, there is a paroxysmal headache, which comes on each evening with the febrile stage, and de- clines along with it. This headache is generally accompanied by a lameness and stiffness in the muscular cords on one side or another of the neck. The heat of skin is very marked, and pungent enough almost to burn when one touches it. It resembles the contact with a hot iron or stove, and gives one the sensation as if it would siss should we apply the washer- woman's test to the surface. After some hours, this symptom is almost entirely wanting. The general heat of the skin has declined, but there is no moisture to follow in its train, or minister to its relief. When the febrile paroxysm has passed away, the cutaneous integment has cooled oft, and no excess of temperature is observable anywhere upon the surface of the body, save around the neck, and in the axillae and the groins. When the type of the fever is continuous, this symptom per- sists for a longer period. In either case, however, it appears characteristic that its decline is almost never accompanied by a free flow of the sensible perspiration, neither by a copious diuresis. We shall draw a therapeutical hint from this fact a little farther on. In a majority of cases, the pulse is much the same as in the ordinary infantile remittent fever. During the febrile exacer- bation, it will, as a matter of course, be considerably accelera- ted, its regularity, frequency, etc., being modified by contin-
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