Lectures on the acute specific diseases : being the Gulstonian lectures, delivered at the Royal College of Physicians, March, 1853 / by William Jenner, M.D.

  • Jenner, William, Sir, 1815-1898.
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the acute specific diseases : being the Gulstonian lectures, delivered at the Royal College of Physicians, March, 1853 / by William Jenner, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    11 agree in having an eruption on the skin, the nature of the eruption varies in each. In small-pox, it is a spe- cific suppurative inflammation ; in scarlet fever, it is dif- fused vascular engorgement, commencing in the most minute points; in measles, it is also vascular engorgement, but commencing in spots of some size; in typhus fever, there is a similar distension of the capillaries of the skin at detached spots at the outset, but terminating, before the conclusion of the disease, in a large proportion of cases, in rupture of one or more minute vessels in each spot. In typhoid fever, the eruption is due apparently to an increased flow of blood only to detached points; and rupture of the vessels at those points never occurs. The spots I have seen in relapsing fever have been evidently caused by cuticular haemorrhage. In erysipelas, the skin affection appears to be inflammatory in nature, and it is accompanied by one of the effects of inflammation, viz., eff'usion of serosity. Peculiarities in Respect of the Parts of the Skin Affected.— The eruption in each of these diseases appears first on parti- cular parts of the body, or limits itself throughout to parti- cular parts. In small-pox and measles the eruption shows itself first on the chin, nose, or forehead, and thence invades the whole face. In small-pox the skin of the wrists next suffers, while in measles the rash gradually passes from the face to the neck, thence to the trunk, and subsequently to the extremities. In scarlet fever the eruption breaks out first on the root of the neck, upper part of the chest, loins, and outer aspect of the arms. In typhus fever, the back of the hands are often the seat of the earliest spots; subsequently, the trunk and extremities; and it appears on these latter parts almost simultaneously. In typhoid fever, spots scarcely ever appear on the face, and rarely on the extremities. They are, perhaps, more numerous on the posterior surface of the trunk, but their characteristic appearance is best seen on the anterior. In erysipelas, the inflammation commences about the centre of the face—e. g,, over the lower part of the nasal bones—the pohit of the nose, or the centre of the upper lip, or a little to one side of these parts. As to the Period after the Outset of the Disease at which the Skin Affection appears, its Course, and Duration.—In re- lapsing fever, if there be a specific skin affection, it appears on the first day of illness ; the rashes of scarlet fever and of erysipelas show themselves on the second; that of small-pox on the third; of measles on the fourth; of typhus fever on the fifth ; of typhoid fever on the eighth. While in relapsing fever the duration of the rash is less than twenty-four hours; in measles, three or four days ; in scarlet fever, six or seven days; in erysipelas, seven or eght ^days ; in small-pox, ten or twelve days; in typhus fever, ten or twelve days; and, in typhoid fever, twelve to twenty days. In their course, these skin affections present certain pecu- liarities. Thus, in scarlet fever, measles, and small-pox the eruption disappears first from the parts first affected; so