Physical diagnosis : a guide to methods of clinical investigation / by G.A. Gibson and William Russell.

  • Gibson, George Alexander, 1854-1913.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Physical diagnosis : a guide to methods of clinical investigation / by G.A. Gibson and William Russell. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    Hypersemia of distinct papillse gives rise to the formation of 'pa'pules, whicti are small rounded elevations. Flesh- coloured papules arranged in groups are found in prurigo, and dull red papules, also aggregated together, are character- istic of lichen. Papules occur in the course of several acute general diseases. In typhus they are rosy and have a tendency to become petechial; in enteric fever they are pink and appear in successive crops; in scarlatina they are minute and scarlet, usually coalescing to form a uniformly distributed rash : in measles they are dull red and somewhat crescentic in outline ; and in rotheln dull red, but paler than in measles, grouped in clusters over the body, but uniformly distributed over the face. Papules form the initial stage of eczema and other skin diseases to be noticed presently, and they are also foiind in the early period of small-pox, cow-pox, and chicken-pox. Hyperemia of the vascular layer, along with exudation around the papillae, gives origin to pomphi, which are rounded elevations with a pale centre and a red halo, highly characteristic of urticaria or nettle-rash. Firm pressure causes the disappearance of the coloured zone. Accumulations of serum, consequent upon hyperasmia, and having their seat in the rete Malpighii, or between it and the horny layer, constitute vesicuhe and bullcv, which are only distinguished from each other by their difference in size. Vesicles, which should not, strictly speaking, exceed a pea in size, are found in hydroa, where each bleb is situated on a distinct red base, and herpes, in which they are at first separate and surrounded by red zones, but afterwards become closely grouped together, and frequently coalesce. It is to be noticed that in herpes zoster the vesicles are developed along the course of distribution of nerve trunks. Vesicles occasionally develop at the summit of the papules in lichen, and form the second stage of eczema ; they not infrequently attend erysipelas, and are highly suggestive of scabies when localised about the hands, and more especially the webs of