A clinical text-book of medical diagnosis for physicians and students based on the most recent methods of examination / by Oswald Vierordt.

Oswald Vierordt

Date:: 1900

Credit: A clinical text-book of medical diagnosis for physicians and students based on the most recent methods of examination / by Oswald Vierordt. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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$the acUlilional service of washiiii; away the poisons which have accumu- lated ckiriiii^- the course of the disease. Tlie most important instances are {a) the critical sweat of a rapid definite decline of the fever, espe- cially frequent in pneumonia and febris recurrens [relapsing fever] ; {b) the sweat which regularly accompanies the fall of temperature in inter- mittent fever and pyemia (diseases which manifest themselves by rapid rise and fall of temperature), the night-sweats of the hectic fever of phthisis, and the sweat of the remittent (hectic) fever of typhoid fever; and (<r) the cold sweat of collapse (that is, the sudden failure of strength in the death-struggle). Acute artiailar rliciimatisni manifests itself by considerable poison- ous perspiration, which may not depend upon a fall of temperature ; this is also true in rachitis. Finally, there is always the inclination to perspiration in the commencement of convalescence from severe dis- eases and in parturient patients, when there is great weakness and the vascular system is easily excited. Local siveating occurs in various neuroses, also in organic diseases of the nervous system. There is very frequently sweating of the whole of one side {Jicinidrosis) or of the head alone, as in Baselow's disease, migraine, hysteria, localized disease of the brain, and in mental diseases. DiininisJied secretion of sweat, even to complete anidrosis, is ob- served chiefly in high continued fever. It is, moreover, a peculiarity of all diseases which are accompanied with considerable loss of water by the bowels or the kidneys, of severe diarrhea of any kind, con- tracted kidney, and diabetes. The anidrosis which exists with general dropsy, in consequence of the anemia of the skin produced by the pressure and stretching, has a peculiar appearance.^ The anidrosis of high fever and general dropsy is very persistent, sometimes resisting all therapeutic measures, as, for instance, those acting directly upon the skin (moist heat, etc.), and the medicines already mentioned. Qualitative alterations of sweat exist sometimes in severe jaundice,^ when it contains the coloring matter of bile and is yellow in color; also, when the urinary secretion is greatly diminished or entirely sup- pressed, as in nephritis, diseases of the urinary tract, and cholera. It then sometimes contains considerable quantities of urinary products, which in some cases, by the evaporation of the perspiration, crystallize upon the skin (especially upon the nose and forehead) in small white scales. This is called 7iridrosis, the scales giving the reaction of urinary ingredients. Occasionally, however, they consist only of common salt. C. The Color of the Skin. As is well known, races differ in the color of the skin, but even in the Indo-Germanic race there are variations depending upon the stock, the climate (blond, brunette). In some nations the pale, in others a more florid, complexion, especially of the face, preponderates. We know that there are differences depending on the mode of life ; also that, even as regards the so-called healthy color of skin, considerable ^ See under E. 2 See under Icterus.$