Licence: Public Domain Mark
Credit: A manual of medical diagnosis / by A.W. Barclay. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
93/642 (page 69)
![Ids to injection of tlie conjunctiva}; in catandi and inflnenza it ■ ccts the throat and hronchi. I liave felt for a moment j)erj)l(;xed I the etl'ects of a fit of crying in a young person witli slight febrile ■nturbance, and the hint may ho useful to others. 22. The .sore throat of scarlatina is characterized by diffuse reil- <-ss of the fauces, without tumefaction to any extent in the first ■Btance. That wliich sometimes accompanies simple fever j)re- Duts less diffuse redness; in quinsy it is always associated with well swelling. In all of these the distinctions derived from mrile s^unptoms are to be viewed in connexion with the local ante ; when the characters of scarlet fever most nearly approach t typhus the redness is most marked, and it has a livid hue ; in liiinsy, when the swelling is so slight as to cause any doubt, the •urile state is scarcely ap]ireciable. The sodden tongue of quinsy K'.s always but little analogy to that of fever. I In a well-marked case of scarlatina, there are generally to he cen on the tongue a number of round elevated jnipilhe, winch, in • e early stage, protrude through a white fur, giving it a dotted ppearance, and at a later period stand out from tlie smooth red rrl'ace, producing what is generally spoken of as the “ strawberry” : ngue. This appearance cannot serve for the diagnosis of doubt- ! 1 cases, except, perha]).s, in a retros])ective view. t.3. d'he pain of the back in variolous attacks is sometimes most v.markable. It is more inten.se than any similar condition ob- rrved in ordinary fever, in which pains in the limhs generally are nre to acconqiany any local pain in the back, and dejiressinn is ob- 'rved rather than excitement; the fever existing prior to the erup- cn of smallpox, wlien pain in the back is felt, is usually of an utive form. A distinction between this local pain and that of mibago, in the general acceptation of the term, is to be found iii 'S locality: the latter affects the muscles at the side of the sjiine, ad is, consc(piently, much aggravated by movement ; the former I more central in situalion and is less affected by change of osture. The subject of nephritis will occupy us at a later jicriod. ther causes of jjain in the back are not atteniled witli sj’inptoms f fever. Eruptive fevers vaiy very greatly in intensity jirior 0 the appearance of the cutaneous alfection; and it ortunately liappens that, when the fever is most severe, I'lie local indications just mentioned are most striking. ' n slight cases, where the practitioner is most likely to ■oe thrown olf his guard, he is seldom called till the ■|.,ppearance of the erujition leaves no room for hesita- idon as to the cause of the attack. The eruptions jiresent certain distinct forms, which,](https://iiif.wellcomecollection.org/image/b24989812_0093.jp2/full/800%2C/0/default.jpg)
