Volume 1

A text-book of medicine for students and practitioners / by Adolf v. Strümpell.

  • Adolph Strümpell
Date:
1911
Catalogue details

Licence: Public Domain Mark

Credit: A text-book of medicine for students and practitioners / by Adolf v. Strümpell. Source: Wellcome Collection.

    71/874 page 43
    related—the association being based upon the alleged finding of the same spirilla in both cases, and on the alleged transmission of blood from a patient with “ bilious typhoid77 to a normal individual, with a resultant development in the latter of an ordinary recurrent fever! Recent studies cast consider¬ able doubt upon these observations, so that the nosological situation of “ bilious typhoid 77 is at present not decided upon. Prognosis.—The prognosis of ordinary relapsing fever is on the whole very favorable. I11 the last epidemics the usual mortality was only two to four per cent. The fatal cases could some of them be laid to wretched nursing. In the remaining portion death resulted from complications, such as pneumonia and nephritis. Treatment.—The treatment must as yet be purely symptomatic. Anti¬ pyretic treatment is generally needless, since the fever is relatively brief and often quite intermittent. Moreover, most patients cannot well endure cold, baths, because the muscles are so painful. As a rule, good nursing and proper food amply suffice. If the muscular pains are very violent, we may order chloroform liniment as an embrocation. Complications are to be treated on general principles. We are not acquainted with any remedy that can influence the disease itself or avert the relapses. Large doses of quinin, salicylic acid, etc., have been frequently employed for this purpose, but never with success. Lately there has been ascribed to calomel a favorable influence upon the general course of the disease, and its use is said to diminish the number of attacks. We must await further evidence in support of this statement. CHAPTER IV SCARLET FEVER (.Scarlatina) We now begin the consideration of those acute infectious diseases which are usually embraced under the name of the “ acute exanthemata.77 In this group are reckoned, besides scarlet fever, measles, German measles, smallpox, and varicella. Typhus may also be included in this group with a certain amount of justice. The point which these diseases have in common is that in all of them is developed a characteristic eruption, of slight clinical significance in itself, in most cases, but of thoroughly characteristic appearance in each dis¬ ease, and hence of essential importance in diagnosis. A number of the acute exanthemata have this further point of mutual resemblance that they appear chiefly in children. These diseases are scarlet fever, measles, German measles, and varicella. ^Etiology.—Infection with the specific scarlatinal poison occurs almost al¬ ways by contagion, which takes place very readily. A single approach to a patient ill with scarlet fever may suffice to communicate the disease. There is no doubt that the disease may be transferred by objects which the patient has touched, such as linen, clothing, furniture, or toys. Persons who have been
    digitised image 1
    digitised image 2
    digitised image 3