Impetigo contagiosa : its individuality and nature / by Henry W. Stelwagon.

  • Stelwagon, Henry W. (Henry Weightman), 1853-1919.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Impetigo contagiosa : its individuality and nature / by Henry W. Stelwagon. Source: Wellcome Collection.

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    up, and passing to a consideration of other questions raised by Dr. Hyde’s theory, the next point suggested is: Can a pustular disease be so modified by a pre-existing contagious disease, which had some time previously occurred, as to present an entirely different clinical picture? I know of no example or proof in substantiation of this. Admitting, however, that such can take place, can such a modification be possessed of such characters as to propagate itself in its own modified form? If so, then there is a new disease, entirely differing from the original disease, and totally distinct and independent. I do not believe, however, that such can take place; clinical observation is against it, and it lacks both positive and negative demonstration. The clinical features of the two diseases are markedly different, and cannot be easily confounded. If the disease is not a variety or modification of another disease, and its clinical characteristics are so distinct and different from other diseases, the conclusion must be reached that the process is an independent one, and the individuality of the disease must be admitted. This granted, the nature of the disease demands consideration. In regard to this point but few observers • are in accord; some viewing it as a parasitic disease, others opposed to this, and others again holding aloof and advancing no opinion. The eruption has distinct contagious properties; is inoculable, as well as auto-inoculable ; to these facts most observers agree. This being the case, this contagion must be derived from a constitu¬ tional or local source. The question of the local source of the contagion, or the parasitic view, will be first considered. Some points regarding the parasitic theory have been una¬ voidably touched upon in discussing the individuality of the disease, and a certain amount of repetition may be necessary. Several observers, most notably Kaposi1 and Piffard,2 have attributed the disease to the presence of a fungus which they have discovered in some of the crusts. This view is, however, materially weakened at the start by the fact that in almost all instances the discovered fungus has been different from that discovered by others. Almost every observer has, in fact, been able to demonstrate the presence of a fungus in a few crusts, but many look upon it as accidental, a view which Kaposi, one of the first supporters of the fungus theory, subsequently adopted. Others, again, most conspicuously Unna, consider the disease, in all probability, due to a fungus, but admit that as yet the fungus has not been found. No one has been able to demonstrate a fungus in the contents of the lesions. It is not at all surprising that fungi have been detected in some of the crusts, for it is well known that fungi may float about in the air, and may lodge upon anything exposed. Take the crusts of any disease, the non-parasitic nature of which is unquestioned, and the same result will be obtained. This I have done with the crusts of eczema and dermatitis, and in them I