A practical text-book on infectious diseases / by R.W. Marsden ; with a chapter on puerperal septic disease by A. Knyvett Gordon.

Date:
1908
Catalogue details

Licence: In copyright

Credit: A practical text-book on infectious diseases / by R.W. Marsden ; with a chapter on puerperal septic disease by A. Knyvett Gordon. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    examination a good light is essential.] Each spot is surrounded by a red areola. They have been described as occurring in 8o per cent, of the cases, but I have personally only observed them on very few occasions. They are said to arise one to three days before the characteristic eruption on the skin appears, and to persist for two or three days. The white dots cannot be removed by swabbing. This fact, as well as the existence of an areola round each, serves to distinguish them from small particles of food or milk. In the earlier part of the period of invasion the temperature reaches ioi°F. or i02°F., the evening record being higher than the morning one. Often on the third day there is a more or less complete remission of pyrexia, which returns, however, with the appearance of the exanthem, and even proceeds to a higher level than before, e.g., i04°F. or io5°F. The tem- perature usually reaches its maximum with the maximum development of the rash. Thereafter in uncomplicated cases it terminates somewhat suddenly’, the persistence of distinct fever after the rash has faded being evidence of some com- plication, e.g., broncho-pneumonia or otitis media. In the catarrhal stage also there may be hoarse- ness with a frequent loud barking cough, and evidence of laryngitis, unaccompanied at first by any expectoration This catarrhal laryngitis may even be the cause of laryngeal stridor with symptoms of laryngeal obstruction, which should not be mistaken for membranous croup. This error will be avoided by noting the accompany- ing coryza, and by the discovery of Koplik’s