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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    liis surroundings. But this is often quite out of the ques- tion. Nearly every one has met with cases both of scarlet fever and of other infectious diseases where it is abso- lutely impossible to trace any source of infection, where even it would seem probable that none could exist. It will, therefore, not be a matter of surprise that we shall very often be unable to avail ourselves of this proof positive. Consequently we must at the outset admit the great difficulty of defining with precision what collection of symptoms shall entitle us to pass a verdict of scarlet fever. Rash, sore-throat, albuminuria, desquamation may each of them be absent, or may vary to almost any extent; and while the coincidence of several of these symptoms renders a diagnosis tolerably easy, the absence of one, or more than one of them, by no means indicates that the case is not one of scarlet fever. All we can do is to examine carefully and honestly the cases at our disposal, and to see whether they, indivi- dually and collectively, present such an aggregation of symptoms usually found in the disease in question as to afford a reasonable presumption of their nature. Where we can actually demonstrate a source of infection, our arguments will be thereby so much the more strength- ened. Let us then, with these reservations, examine carefully the details of the cases available for our purpose, to many of which brief allusion has already been made. Among the eleven cases of eruption after operation instanced by Sir James Paget, particulars are given only in that one which served as the text for his remarks. In it, besides the rash described as exactly like that of scar- latina which appeared on the day after the operation, there occurred also general febrile disturbance. These symptoms subsided in a few days; but at the end of a 1 month the patient had severe pain in passing Avater, with ' marked kasmaturia. Tavo days afterwards there Avas sore- • throat, and the eruption reappeared and continued for ten days. In another ten days the urine became normal, and the boy eventually recovered. In the remaining ten cases avc have no individual par-