Lectures on clinical surgery. Vol. I. Pt. I. On certain rare diseases of the skin / by Jonathan Hutchinson.

  • Hutchinson, Jonathan, Sir, 1828-1913.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on clinical surgery. Vol. I. Pt. I. On certain rare diseases of the skin / by Jonathan Hutchinson. 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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    10 an epidemic of varicella at the Necker Hospital^ some cases -were protracted for six weeks^ and passed into an ulcerating form of eruption, looking like pemphigus. You will find the lecture in the second volume of the New Sydenham Society's translation, and it is well worth reading. Trousseau does not mention prurigo as having been a marked symptom, nor does he say anything about the eruption having occurred on the palms or soles, and he mentions the period of two months as if it had been the extreme limit of dura- tion. Now, in all my oases, the pruriginous element has been a very marked one; the condition of the palms and soles has been a peculiar feature; and the duration of the eruption has been much longer. Case 1.—Rosina 0—, aged 18 months, was admitted on February 19th, 1869, suffering from a very copious eruption of vesicles or small bullae on the extremities, trunk, and face. It avoided the flexures, but was very marked on the soles and palms, and this latter feature led to the suspicion that the case might be scabies, hut there was no evidence of the presence of the itch mite. The vesicles when commencing were veiy firm and felt quite shotty. The eruption had already lasted four months, and the mother’s clear statement was, that it appeared all over the body at once, and that the doctor to whom she took the child considered the disease to be smallpox. She stated that there had been some spots on the head. The rash was attended by great itching. The patient was pale, hut seemed in other respects healthy. She remained under treat- ment for five months without any material permanent improvement. The spots altered somewhat in character ; some of the later bullae were as large as peas, and it was noted after the child had been attending for some months that many of the spots passed into pustules. As the child was eighteen months old, no doubt she had been vaccinated, but my notes do not mention this point. Case 2.—Edward B—, aged 16 months, came under my care in May, 1869. He was pale, and seemed out of health. He presented a copious eruption of vesicles and papules in various stages, and affecting the face, trunk, and limbs, and, to a slight extent, the scalp. The fresh spots consisted of elevated pointed papules, feeling very firm, and each surmounted by a small vesicle. In the older ones the vesicle had sometimes broken, but in the greater number it had dried up; on the scalp the spots had sometimes run on to