Transactions of the international Medical Congress : seventh session held in London, August 2d to 9th, 1881. Diseases of children / prepared for publication under the direction of the Executive Committee by Sir William Mac Cormac ; assisted by George Henry Makins and H. B. Donkin, R. W. Parker.

  • International Medical Congress
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Transactions of the international Medical Congress : seventh session held in London, August 2d to 9th, 1881. Diseases of children / prepared for publication under the direction of the Executive Committee by Sir William Mac Cormac ; assisted by George Henry Makins and H. B. Donkin, R. W. Parker. Source: Wellcome Collection.

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    symptoms;* in the eighth t (one of empyema), not till the sixth day after access of febrile symptoms, but the twelfth after exposure. III. —The Catarrhal Symptoms and Affection of the Air Passages exhibited certain special features. There was injection of the conjunctivse; usually slight sneezing at the onset, which soon passed off; little running at the eyes and nose, in many cases none; no intestinal flux. On the other hand, the hoarseness and irritation of the throat were extreme, and the cough incessant, laryngeal, croup- like. In one instance this was harassing beyond anything I have ever seen. The patient (a boy of ten years old), could not be kept in bed, but stamped about the room in distress so intolerable that chloroform had to be freely given to relieve it. In one case the respiration became difficult and stridulous; the tonsils, fauces, and soft palate were dusky red, much swollen, and covered with tena- cious mucus. Enlargement of the glands at the angle of the jaw was observed in one or two instances. In one there was a film of coherent membrane on the tonsils, and albumen in the urine. | Marked bronchitis, evidenced by sibilant respiration and abundant fine rales at the bases, was present in all but the mildest cases. In two, broncho-pneumonia supervened. The contrast between the two epidemics in regard to these symptoms was striking. In the first, incessant sneezing, coryza, lachrymation, comparatively slight hoarseness, frequent but not severe cough, some diarrhoea. In the second, little or no sneezing, coryza, or lachrymation, extreme hoarseness, incessant severe crouplike cough, marked implication of the larynx and bronchi, entire absence of catarrh of the intestinal mucous membrane. IV. —The Eruption presented some points of divergence from the normal measles’ rash. It was more raised, more coarse and papular ; the grouping of the stigmata was not crescentic, but in irregular blotches, and of a darker, more purple hue. In the severest cases it was confluent on the face and backs of the wrists and hands, accompanied by much swelling. In one instance there were petechiae and small purpuric patches on the extremities; and in this case the livid papular petechial rash and the swollen face and hands bore at first sight a strong resemblance to the condition in severe smallpox. In two instances of more moderate intensity, but contracted from one of the more virulent cases, the confluent eruption on the face and limbs, in place of being purple and papular, was diffuse and rosy—closely simulating in these points the rash of scarlatina—elsewhere of the patchy, purple, measles form. In all these cases the eruption did not reach its maximum until the third day, the most intense not beginning to decline until sixty hours, or even more, after its lirst appearance—i.e., at the close of the third or beginning of the fourth day. V. —The Eruptive Fever ran high. The temperature went up to 103° as the rash came out, and continued to rise a little until the eruption reached its height, and ran up to 104° or 104'5° at the maximum. In the majority of in- stances the temperature began to fall on the fourth day of eruption ; but in two, in which there was no complication, it remained at 103° to 104° for two days later, or the fall did not fairly commence until the sixth dajb Ihe pulse ranged from 130° to 160° at the maximum. In one case (A. C.) C., L. M., L. and M. F. (private cases). Coates, Parkins (Children’s * W. and F. Hospital). t A.diwel] (Children s Hospital.) Exposed, November 10. First symptoms, November 17 (rise of temp, to 100-8°, continuing up to eruption). + In an epidemic of measles which prevailed contemporaneously at Folkestone, and which probably was of the same generic form, the affection of the throat was equally pro- mi nen . .r0,n ^r- ^ y«on of that town, who has kindly written to me with this n orma .ion, la m three cases the laryngeal obstruction was so great that tracheotomy hact to be performed ; in another the operation was threatened, and that other cades of a similar kind had occurred.
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