A treatise on the nature, causes, and treatment of erysipelas / by Thomas Nunneley.

  • Nunneley, Thomas, 1809-1870.
Date:
1844
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the nature, causes, and treatment of erysipelas / by Thomas Nunneley. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    serous membranes frequently supervene upon external erysipe- las is well known, but then it is not erysipelas, it is said.p If by erysipelas be meant inflammation of the skin alone, this is self- evident, but if it be meant that the disorder is no longer of the same nature, I ask for the proof of its difference. If occurring at the same time; alternating with the external affection; being accompanied by the same general symptoms; having, as far as the situation and structure of the parts allow, the same local symp- toms; producing the same results ; and requiring the same treat- ment : moreover, one form of the complaint producing the other form in a second person, be decisive of identity of nature, then, most assuredly, these two forms are but varieties of one disease. I might fairly refer to the preceding statements respecting the con- current existence on the one hand, of puerperal fever and erysipe- las; and on the other, of the identity of puerperal fever with diffuse peritonitis occurring under other circumstances than recent delivery; because if these two propositions be correct, then' also the third, viz., that diffuse peritonitis and erysipelas are the same disease, must be admitted. However, we are not obliged to adopt this indirect, but conclusive mode of arguing.i The four follow- ing cases, the two first from Dr. Abercrombie, the third seen by Dr. Alison, and the fourth as witnessed by myself, are very strong evidence upon this point, and afford direct proof upon the question. A lady, aged fifty years, was seized with erysipelas of the left leg, attended with much pain and swelling of the foot, after seven days the erysipelas of the leg subsided, leaving the foot unrelieved, but upon the eighth the foot also became suddenly well, and within a few hours after, severe pain was complained of, first in the epigastrium and then in the lower part of the abdomen. This pain was not much increased by pressure, but she moaned much, was anxious and restless, pulse 100, bowels open; bleeding, and the other usual means were ineffectually employed ; her strength sunk, and she died about twenty-four hours after the matastasis. Inspection—The upper half of the small intestines was of a dull leaden colour, the lower half of a very dark red, the whole much distended, and a considerable quantity of bloody sanious fluid in the sac of the peritoneum. Besides these there were no other ves- tiges of disease. A woman, aged thirty, while convalescing from an attack of erysipelatous inflammation of the throat, took some laxative medi- cine, which unusually annoyed her, and shortly after pain of the abdomen came on, attended with vomiting. The pulse frequent p Copeland's Dictionary, art. Erysipelas. q Van Swieten says :— But the disease (erysipelas) is the most danger- ous if it affects the membranes of the brain, the lungs, or other viscera, where it readily spreads. From whence also Galen has remarked that erysipelas remains chiefly about the skin, as well that which is external and is the common tegu- ment of all parts of the body, as also that which is thin and membranous and surrounds each viscus. — Van Swieten, vol. ii., p. 400.