Observations on certain eruptions of the skin which occur after recent operations and injuries : a thesis for the degree of M.D. in the University of Cambridge / by Edward C. Stirling.

  • Stirling, Edward Charles, 1848-1919.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Observations on certain eruptions of the skin which occur after recent operations and injuries : a thesis for the degree of M.D. in the University of Cambridge / by Edward C. Stirling. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    It will be seen that the symptoms followed the opera- tion Within 24 hours in 16 cases, or 25-4 per cent. On the 2d day in 18 „ „ 28'G „ „ 3d day in 15 „ „ 23'8 „ Beyond the 3d day, but within 1 week, in 14 „ „ 23-2 „ Total . . .63° Thus we find that while all the cases occurred within a week, in 49, or 78 per cent, the eruption appeared within three days, reckoning only those in which precise dates are given. This number would be still farther increased if we were to add, as we might fairly do, those cases in which no definite period is stated, but in which it is nevertheless remarked that the symptoms followed, or immediately followed the operation. The mean of the periods in which the time is definitely stated is almost exactly two days.f Surely this indicates some relation between the wound and the fever. For if this were not so, there would be no reason why the symptoms should not sometimes occur at longer and variable periods afterwards, and sometimes also before. But we see, on the contrary, that the fever % almost invariably occurs within two or three days, and often within a few hours of the operation. In explanation of this Sir James Paget offers two alternative suggestions. ‘ Either,’ he says, ‘the condition induced in a patient, by a surgical operation, is one that gives a peculiar liability to the reception of an epidemic or contagious morbid poison, and any oue of these, being imbibed imme- diately after the operation, produces its specific effect in much less than the usual period of incubation: or else those who suffer with scarlatina within a few days after * In the great majority of the cases the rash was the earliest symptom noticed, and the periods referred to indicate the time at which this was first observed. Occasionally, however, premonitory symptoms were previously noticed. f This period, it will afterwards be shown, is probably less than the mean time of incubation in ordinary cases of scarlet fever uncomplicated with wounds, and the shortness of this period is much insisted on by writers who have noticed the phenomena in question, as being characteristic of scarlet fever occurring under these circumstances.