North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826Various
History
North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826
Various
Medicine -- Periodicals
The _confluent_ was ushered in by symptoms of greater febrile disorder
than the regular distinct variety: the throat was sorer; eyes more
suffused and watery, and more intolerant of light; gastric and pulmonic
uneasiness, and oppression more aggravated. In place of the papulae being
separate, or merely in clusters, they are so crowded, that on the
progress of the eruption the vesicles first and then the pustules are
contiguous at their bases, and often run into each other, forming at
times, a large irregular bag filled with pus, and technically called
blebs, or else exhibiting over a considerable space of skin the
appearance of imperfect vesication. The vesicles and pustules are, in
such cases, flattened, and with indented centres, which latter display
at times a dark point or spot, while the edges are of a livid red. This
is the appearance of the limbs and trunk. The cheeks and forehead during
the process of maturation present a continuous puffy elevation of a
pearly white colour. The eyes are nearly closed by the swelling of the
lids, and the thick copious secretion from the borders and the
conjunctiva; the lips are tumid and the angles of the mouth ulcerated.
In fact the human face divine, deprived of all lineaments and
expression, is now a foul, misshapen mass. Associated with this state
are swelled throat, rendering deglutition very painful--salivation,
cough--occasional vomiting, delirium, sometimes phrenitical, sometimes
evidencing itself in low mutterings and jactation.
The _roseate_ variety of small-pox might, without creating much
confusion, be ranked with the confluent, which it closely resembles in
its second stage. The first is characterized by the rose or pink colour
of the face, which is covered with a copious eruption of papulae, some
with dry points, while from others, the bases of which are small and
hard, arise minute vesicles of a pearly colour, which soon dry away. The
inflammation, however, still continues, but spreads under the cuticle,
which is raised in large patches of a white colour, but not vesicular,
or distinctly pustular, or containing fluid: they approximate and
produce the continuous puffy elevation already described. On the trunk
and extremities, the eruption is either of confluent patches or of
pustules dry and flat, with indented centres, the intermediate skin
being of a deep red or crimson colour.
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