The Practitioner. May, 1869.: A Monthly Journal of Therapeutics — John Shaqi
The Practitioner. May, 1869.: A Monthly Journal of TherapeuticsVarious
Science
The Practitioner. May, 1869.: A Monthly Journal of Therapeutics
Various
Medicine -- Periodicals; Therapeutics -- Periodicals
During the time that has since elapsed, I have continued to employ the
same remedy with the same good results.
This form of the disease generally presents itself in fat, red-faced
children who have the appearance of robust health. On questioning the
parents, they will perhaps inform you that the child was but small and
puny at birth, and for the first few months of its life it was sickly
and delicate, and not until lately had it become so stout and healthy.
They attribute the change to the purer air the child now breathes, for
they have removed from a populous and unhealthy district to one less
crowded and decidedly more healthy.
In such a child we find traces of constitutional defect in enlarged and
rickety joints, a head big and ill-shapen, and an anterior fontanelle
not completely closed. We find a thick and prominent lip, conspicuous
for the extent of mucous membrane it shows.
The intolerance of light is so intense that the child cannot bear even a
moderate degree, but persists in burying its face in its hands, or
hiding from the light in some dark corner. But what strikes us so
forcibly, and what really is so characteristic of the case, is the fact
that the patient’s face is disfigured with patches of herpes,—a fact
which makes us hopeful, as these cases are as a rule the most amenable
to treatment. To cure the disease of the skin is to cure the disease of
the eye in the most rapid and satisfactory manner.
In the majority of the cases which have come under my care, the eruption
was confined to one-half of the face below the brow. In a small
proportion the side of the nose was not affected, and in several the
skin of the upper lip and chin escaped altogether. The vesicles in most
of the cases appeared to follow the course taken by those branches of
the infra-orbital nerve which supply the skin of the face.
My notes do not supply me with any case where the eruption invaded the
brow, although I may have overlooked some such case in my earlier
investigations on the subject. The eruption was often accompanied by a
febrile condition more intense than I have ever met with in the other
forms of strumous ophthalmia.
Before proceeding to active treatment, instructions regarding diet,
regulation of the bowels, &c. should be given. The diet should be
plentiful, simple, and nutritious; and all articles of food likely to
unduly tax the digestive powers (which are as a rule weak in such
children) should be carefully avoided. Strict attention should be paid
to the bowels, which ought to be opened at least once during each day,
but oftener if the appetite be faulty, the tongue loaded, and the fæces
light coloured and of bad odour. These preliminary instructions having
been attended to, special treatment may be adopted.
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