Domestic medicine and surgery : with a glossary of the terms used therein / by J.H. Walsh.

  • John Henry Walsh
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: Domestic medicine and surgery : with a glossary of the terms used therein / by J.H. Walsh. Source: Wellcome Collection.

    52/846 (page 32)
    vesicle may be detected in the middle of each pimple, and this, if carefully examined, will be found to have a depression in the centre, and to contain a colourless fluid. It is surrounded by an inflamed margin, which is called areola. By this time the fever has almost wholly disappeared. On or about the siokh day the eruption ex- tends to the inside of the mouth and throat, which become swollen, accom- panied by difliculty of swallowing and hoarseness, the saliva being also in- creased in quantity and becoming thick and ropy. By the eighth day the vesicles become filled with a yellowish matter instead of the previous colour- less fiuid, and hence they are now called pustules. In shape, also, they are changed, appearing almost to ter- minate in a point. The areola extends considerably, the face swells so as in severe cases to form one imiform mass in which all the features are obliterated. From the tenth to the twelfth day the pus becomes of an opaque yellow, a dark spot shows itself in the centre of each pustule, the areola subsides, beginning with the eruption on the face, where the swelling goes off at this time, but extends to the extremities. After the twelfth day the pustules gra- dually become Scabbed by the drying of their contents, which break and discharge ; these crusts or scabs finally fall off and leave the parts beneath them of a blnish bro^vn colour, with permanent indentations, called pits, except in slight cases where they are wanting. In mild cases of smaU-pox, when the pustules are matured, the fever ceases altogether; but in the more severe forms, as soon as the eruptive fever has disappeared, another form sets in, called the secondary, which is characterised by gi-eat and distressing thirst, restlessness, and dehrium. There is more or less general efllorescence of the skin in spots uncovered by eruption, and very often the cellular membrane becomes so inflamed that abscesses form, or erysipelas of a gangrenous nature makes its ravages, masked by the confluent pustules. The inflamma- tion of the throat extends downwards into the lungs, which are often seriously congested or inflamed, or else the bowels or brain are attacked, generally soon ending fatally. 92. In CoNFnuENT Small-pox the above symptoms are well marked, and aU those described are frequently met i with, though somewhat modified iu ! degree. In distinct smaU-pox, the eruption does not coalesce, and the swelling of the face is not nearly so great, nor is the secondary fever well marked, or often accompanied by any of the complications mentioned above. 93. In MoDinED Small-pox the symptoms are considerably altered in severity, and in the period of time which they occupy. The eruptive fever only lasts twenty-four hours, and is not often ushered in by rigor or sick- ness. The eruption shows itself on the face and arms at the same time, runs a much more rapid course, is very seldom confluent, and varies so much i in the form and character of its pus- tules as to be incapable of auy precise description. Some of them generally show the central depression, but the majority are of all shapes, and many of the pimples die away \vithout being capped by any vesicle or pustule at aU. As soon as the eruption shows itself, the constitutional symptoms disappear, though sometimes a slight secondary fever comes on about the sixth or seventh day. 94. It is somewhat difficult to detect smaU-pox in the early stages of its onset, but the severity of the fever, the occurrence of vomiting, and the rigor are pretty good guides, when coupled with the absence of the sullusion of the eyes and the sore throat so generally to be observed iu measles and scarla- tina, the two fevers with which it can chiefly be confounded. 95. The MORTiVLiTY IN Small-pox is about one iu four, but the deaths at the Small-pox Hospital were still higher, the cases being picked and the collection of numbers of them together being ad- verse to a successful treatment. lYhen death occurs prior to maturation of | the pustule, it is generally caused by malignant fever. Between the eighth and thirteenth day the throat 's the chief seat of a fatal complication. 'When