Licence: In copyright
Credit: Vincent's angina / by J.D. Rolleston. 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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![fever, as Simoniii, Veclel and Lagriffoul, and Weaver and Tunnicliff liavo done. Disproportion between the severity of the local and general symptoms is one of the most striking features of Vincent’s angina. In most of my cases the constitutional di.sturbance was slight and lasted only during the pyrexial period, which, as a rule, was of short duration. In 5 the temperature was normal throughout their stay in hospital, though the local process was still in an acute stage on admission ; in 10 it ranged between 99° F. and 100° F. ; in only 4 did it rise above 102° F., the highest reading being 103'8° F. In 11 cases the temperature became normal within twenty-four hours of admission, and in only 2 did the pyrexia persist for more than four days after their arrival. Compared with diphtheria, the specific disease which it most closely resembles, Vincent’s angina is a ])ro- tracted affection. Whereas in diphtheria the throat becomes clean a few days after the injection of antitoxin, the healing process in Vincent’s angina requires as a rule a much longer time. The average period in the 32 cases was eighteen days, the extreme limits being five days in the mildest, and fifty-nine days in the most severe. A still more chronic course has been recorded by several writers. In one of Arrowsmith’s cases the ulceration lasted over two months and involved the right tonsil, anterior and posterior pillars, epiglottis, and pharynx. In Bayer’s case the process lasted between three and four months, and defied all local treatment. Finally recovery took place under arsenic internally and strengthening diet. In Pusateri’s case, in which the diagnosis of tuberculous ulceration of the tonsils was first made, the disease lasted for over a year. Murray and Todd have also recently recorded cases of chronic ulceration of the tonsils associated with the presence of Vincent’s organisms. Two of my cases had a relapse. One occurred on the ninth day, and was probably due to accidental inoculation during painting of the throat, as the child struggled at the time. The other relapse occurred Avithout obvious cause on the twenty-fourth day. In both cases the right tonsil and right side of the uvula were involved in the relapse, whereas the left tonsil and left side of the uvula had been affected in the initial attack. As a rule, the fuso-spirillar couple disappears as healing com- mences. The fusiform bacilli persist longer than the spirilla. In 2 cases in which the organisms Avere found in great abundance on the fifth and seventh days, smears taken on the 10th and 9th days](https://iiif.wellcomecollection.org/image/b22433491_0010.jp2/full/800%2C/0/default.jpg)
