Some accounr of the scarlet fever, lately epidemic in Liverpool / by J.R.W. Vose.

Date:
[1841?]
Catalogue details

Licence: Public Domain Mark

Credit: Some accounr of the scarlet fever, lately epidemic in Liverpool / by J.R.W. Vose. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    It was usually greater on one side than on the other, and was not unfrequently confined to one side only. The inflammation and ulceration at the fauces were often of formidable extent; but the tumors again and again appeared in cases ^vhich were not accom- panied by more sore throat than is constantly observed in scar- let fevers, where no such affections of the neck take place. In a very large proportion of those who did well, the swellings ended _ by resolution,—for although among the three cases of recovery which have been related here, one terminated by suppuration, this must by no means be regarded as any indication of the relative frequency with which these modes of termination were observed. Suppuration was rare ; but, as far as my observation extended, the patients in whom it occurred got well. Where gangrene was set up in the tumefied parts, I did not see recovery; but the oc- currence of gangrene was extremely rare. In most of the fatal cases, death took place while the cervical swelling was still in a state not apparently incompatible with its subsiding by resolution had life been prolonged. During this epidemic, the cutaneous eruption was very com- monly remarked to be more partial, faint, and fugitive, than is generally the case in scarlet fever. Although, from the seventy of the disease, the patients were often reduced to a very cachec- tic state, and convalescence advanced but slowly, dropsical swel- lings seemed to occur less commonly than is usually observed af- ter epidemics of a much milder character. As regards treatment, I have nothing very satisfactory or con- clusive to offer. In those cases which terminated favourably, re- covery took place under the use of very opposite means, as when antiphlogistic, mercurial, and stimulating remedies were employed. Although, in many instances, the patients did well, where ener- getic measures, as free and repeated leeching and severe pu!-gmg, were recommended, this practice, for the most part, seemed to be injurious, by lowering the strength, without exerting any obvious effect upon the progress or condition of the cervical tumors. Upon the whole, a combination of tepid aspersion, warm poul- tices to the neck, and gentle mercurial laxatives, seemed useful; particularly by moderating the febrile action, under which the vital powers rapidly gave way. The cautious but steady use of wine and other means ot sup- port should not, I think, be withheld too long under this form of disease, as these were well borne, even by children of a very ten- der age, as soon as ever the violence of the febrile symptoms was broken. Liverpool, Wih March ]6il'