ON A RARE FORM OF CUTANEOUS ERUPTION— ROSEOLA PUNCTATA.

ON A RARE FORM OF CUTANEOUS ERUPTION— ROSEOLA PUNCTATA.

448 thirty times the extent of the man’s exterior-steam electricity at every expiration-pressure and expansion of all the cells and cavities in the ch...

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448 thirty times the extent of the man’s exterior-steam electricity at every expiration-pressure and expansion of all the cells and cavities in the chest; water passing off in vapour, and vapour condensing into water-all and every one of these being the greatest and best known generators of electricity; - all of them contributing, in health, enough of that vital fluid, or of its elements, to maintain due equilibrium, to revive the animal functions, to support animal excitabilityall communicating a sufficient proportion to parts, or to the whole body, if partially exhausted, and neutralizing or rendering dormant other parts or the whole system, if overcharged

two Mr.

cases.

The first

patient obligingly sent

was a

to

me

by

Jackson, the resident-surgeon of the Royal Free Hospital.. The second was a patient in the Small-pox Hospital, and for the opportunity of observing it I am indebted to Mr. Marsden, the resident-surgeon of that institution. ! The disease is interesting, not merely on account of its novelty, but also from the questionable shape in which it makes its appearance, and from the variety of character which. it subsequently presents. Thus, a resemblance to variola, at its outbreak, caused the patient to be sent to the Small-pox Hospital, while its aspect within the hospital suggested toor overloaded with the vital spirit now under our considera- gentlemen well acquainted with the physiognomy of eruptive tion. ideas of lichen lividus, urticaria, erythema, rubeola, The name given to it by Mr. Marson-namely, 74th.-If electricity be heat, this diffusion of it through an disease, purpura, &c. individual at every breath, presents a simple and most efficient erythema rubeolosum, conveys a good notion of its erythemasecurity for distributing and preserving animal warmth. tous and rubeoloid character; but I have not adopted that Birds, in higher regions of the air, where it is very cold, designation, from a belief that the nature of the disease is. are much warmer than men or cattle below. Is this because better expressed by the term roseola. Roseola, I need hardly positive electricity is the more intense in the air the higher say, bears a close affinity to erythema and rubeola-indeed, im it reaches ? These topics will be again alluded to, but it may some instances, it seems to be a compound of the two; hence a. be here mentioned, that, so much of electrical disturbance as term combining both names, expresses no more than roseola,"’ may take place from untoward currents by the breath, will while the advantage of adding a specific name is lost. With respect to the frequency of occurrence of this disease, affect men and lower animals by inhalations. Is this the Mr. Marson informs me that he has seen about ten cases only, reason that cattle have everywhere, at times, suffered from epidemic inflammations of the lungs ? Cattle can resist the during a connexion of twelve years with the Small-pox. cutaneous transit of electric passes, but are quite amenable to Hospital. The characters of the present affection, according to my those positive and negative excesses affecting the interior surfaces of the mucous membranes, opening from the exterior observation, are as follow :Febrile symptoms of a sub-acute type, accompanied with Surface. If the respiratory machinery be admirably adapted as vol- redness of the eyes, slight coryza, redness of the fauces, and taic piles, the alimentary cavities are equally so as galvanic swelling of the mucous membrane of the mouth, ushering in cells. Endless peristaltic motion and friction chemical an exanthema at the end of three days; the exanthema apchanges between molecules of dissimilar materials-saline and pearing on the mucous membrane and skin; on the latter, m other fluids charging the evolving substances-the liberation the form of small red spots around the mouths of the follicles,. of elements, carbon, oxygen, hydrogen, and nitrogen from then becoming diffused so as to cover the greater part of the their nutritious atoms-hunger exhausting electricity, reple- body, reaching its height on the third day; at first, of a bright tion overloading it-secretions composing and decomposing raspberry-red colour, afterwards acquiring a dull roseate hue, without end; all produce electric alterations in proportion to the dulness increasing with the progress of decline; the pritheir own changes, and all of their phenomena are controlled mary red spots resembling dull red stains as decline advances and regulated by that universal principle of health and life, and fading by degrees, after the disappearance of the rash; the entire attack lasting ten days, of which three belong to electricity itself. It is no wonder, then, if we have contrived to place dis- the febrile period, three to the exanthema, and four to its ordered conditions of mucous surfaces opposite certain de- decline, the dark stains being perceptible for some days after’ grees of electric disturbance, and to risk suggestions, which I wards; the rash assuming a difference of form on differenb trust to render less extravagant in appearance, by showing parts of the surface, such differences being all referrible to "

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hereafter certain their effects.

parallel progress between

these

causes

and

The propositions are not entirely visionary; we find some confirmation of electric capacity in the following able observations of Professor A. T. Thomson, of London:---" Electricity thus accumulated increases the action of the heart and arteries, both in force and velocity; and that this does not depend on any mental feeling, is obvious from the fact that electricity may be applied to animals asleep, and in them the pulse is quickened. The temperature of the body is also augmented, and perspiration excited-circumstances, however, not depending upon the heating power of electricity, but upon the increased velocity of the circulation.* A clergyman in whom I could never produce perspiration by any of the ordinary diaphoretics, and who never perspired by exercise, nor the heat of summer, when isolated and electrified perspired freely. This effect on the skin has been ascribed to the power which electricity possesses of increasing the flow of fluids through capillary syphons; but in the living body it is more probable that it depends on the excitement extending to the extreme vessels." (To be continued.) Merrion-square, Dublin, Sept. 1848. ON A

RARE FORM OF CUTANEOUS ERUPTION— ROSEOLA PUNCTATA. BY ERASMUS WILSON, ESQ., F.R.S. I BEG to lay before the readers of THE LANCET the history of a rare, and hitherto undescribed, variety of roseola, that has lately come under my notice, and of which I have seen only * The loss of weight by the perspiration induced by this means, is greater than in ordinary perspiration. The Abbe Noille electrified a cat for four bours, and found that it lost from fifty-eight to sixty-six grains. Plants " transpire profusely when they are electrified, J’ai vu," says Candolle, (Physiologie Vegetale, tome iii. p.1094,) 11 des plantes perdre en quelques heures d’electrisation une quantite superiure du quart ou du tiers a celle d’une plante non eteetrisee."

roseola. The following is the

history of the case admitted into the Small-pox Hospital:Thomas E—, aged twenty-four, a young man of good constitution, engaged as light porter in a draper’s house in Oxford-street, exposed himself to cold by riding on the outside of an omnibus during the prevalence of the late cold winds. At the end of his journey he felt chilled, and in the course of the same evening he experienced headach, pain in his limbs, and sensations of general illness. Sept. 8th.-On the following morning, after a restless night, he arose fatigued; his headach had increased; his appetite was gone, and he performed his duties painfully and wearily. He was chilly during the day, and in the evening feverish; had a dry mouth, and retired early to bed. 9th.-He had still greater difficulty in getting through his work to-day than yesterday. His symptoms were the same, but increased in severity. At night, after getting to bed, he smoked a cigar, and took a basin of gruel, and being well covered up, broke out in a profuse perspiration. 10th.—This day he scarcely felt able to rise from his bed; but succeeded in getting down stairs and cleaning some knives. While engaged in that occupation he observed an eruption of small red spots on his arms, and soon afterwards returned to his bed. On taking off his clothes, he found his whole body covered with spots, the upper parts being most, ’

and the lower least affected. He remarked also that his eyes looked red, that his lips were swollen, and that there were red spots likewise inside his mouth. llth.-Having been seen this day by a medical man, he was sent to the Small-pox Hospital, under the impression that the eruption was incipient small-pox. At this time the eruption consisted of small red spots, the centre of each spot being very slightly raised, and corresponding with- the aperture of a cutaneous follicle.

12th.—The redness of the eyes, accompanied with coryza a slight degree, the swelling of the lips, and the spotted state of the mucous membrane of the mouth, were at their ia

height to-day, and

to these

symptoms was superadded a cough

making the general symptoms very similar to those of rubeola

449 now become confluent, and assumed the Why this seed of theTriticum Indicum, or Indian wheat, on character of patches, which covered the greater part of the which the pollen has fallen, shall, if put into the ground, bebody. The congested skin was slightly raised above the come a beautiful and useful plant, and this other, to which no level of the unaffected parts, and the colour presented the pollen has had access, shall undergo decomposition, who can say? Who will attempt to explain why those "divinæ partiraspberry hue of measles. 13th.--Through the kindness of Mr. Marson, I had an culse aurse," which exist in the form of pollen, alone can ova ? Who can say what there is in this seed, opportunity of examining the case to-day. The patient’s eyes vivify these were still somewhat congested, his lips were swollen and dry, and what in that pollen-for two such powers are requiredthe mucous membrane of the mouth was thickly covered with which excite development and growth and form, under the red spots, the fauces were red, his,tongue was coated with a appropriate circumstances? white, moist deposit, which was beginning to separate in , But the laws of life may be detected, and their detection flakes, leaving the surface beneath quite smooth, and he and investigation constitute the legitimate objects of philo-

The red spots had

uttered

sophical inquiry.

occasionally a short, mucous cough.

All

The efflorescence had a decidedly rubeolous hue, but offered some variety of appearance on different parts of the body. On his face, which was somewhat swollen, the patches of redness were irregular in form, and diffused. On the trunk of the body, and particularly on the abdomen, the effioresence presented the ordinary rubeolous appearance of common roseola. On the arms and legs the red patches had run together, so as to cover the greater part of the skin, and form a dull, red ground, which was studded all over with spots of a dark red colour. These spots, which I have assumed as the specific character of the eruption, were the original red points by which the efflorescence commenced. They presented a deeper red than the rest of the surface, were about two lines and a half in diameter, and were dark, and slightly raised in the centre. The redness was partly the effect of congestion, and partly of the transudation of the colouring principle of the blood, and in some few situations, as around the and upon the back of his shoulders, where the weight of his body rested, there was a decided ecchymosis from the latter cause. It was obvious that these red points represented the follicles of the skin, in which the inflammation commenced, and the elevated centre was the pore raised above its natural level, as a joint effect of the congestion of the capillary vessels and effusion into the meshes of the vascular network. On the neck, the efflorescence appeared in the form of

in contact with agents which may be termed excitants. On the relative play, action and reaction, of this property, and these agents, life, with all its varied phenomena, essentially

depends. The

degree of excitability, and the quantity of excitants,

a relative proportion to each other; but this proportion is inverse; the greater the degree of excitability the less the quantity of excitants, and vice versâ. Such is the Law of

maintain

Life.

ankles,

patches distinctly circumscribed, slightly elevated, more or less circular in figure, and of an average size of half an inch in diameter.

On careful examination, these patches were be formed bv the confluence of a number of small circular congested spots, each taking its rise around the aperture of a follicle, and many of these separate spots, of about a line in diameter, were sprinkled in the interspaces of the patches. In several of the larger patches, there were one or more yellowish spots, which, at first sight, gave the idea of the elevations of urticaria, but which the changes succeeding on the, following day, proved to be fading points indicating the decline of the congestion. The increase of these pale spots gradually converted the patches into rings, (roseola annulata,) and the latter finally disappeared. I must remark that the spots above referred to were quite distinct from the deeper coloured and stain-like spots on the arms, which suggested the specific name " punctata," which I have given to the disseen to

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,

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.

ea.Hf

14th.—The eruption

living beings, from the worm to the eagle, possess a may be designated excitability, and are placed

property which

The mode of life varies with the quantity of excitant: as this is augmented, life is more active; as it is diminished, life is more reptile. The bird, with excitants in the highest degree and the lowest degree of excitability, mounts into the regions of the atmosphere. The eft and the frog, endowed with the highest degree of excitability, and urged by the lowest degree of excitants, move slowly in our marshes or pools, and in the winter season, when the excitants are still further reduced, become absolutely or nearly inactive. Such are the modes of life ; such the law of their existence; such their rationale. There is another topic which may be slightly touched upon in these preliminary remarks-the form of living beings. But this question is, I believe, beyond the powers of the human intellect. It is the expression of the Divine "fiat," and calls fur our admiration, not for inquiry. Why this acorn is destined to produce the oak, and why this egg is destined to become a bird, the Creator only knows. The laws of the forms, like the laws of the modes of existence, can alone be submitted to investigation. But what is this excitability, and what are these excitants, whose mutual action gives origin to the phenomena of life ? In replying to this question, I must lay before my reader certain facts with which he may not be familiar; but they are elementary, and only require to be witnessed, or well apprehended. If we decapitate a frog, in order to remove all sensation, all faculty of suffering, and then detach a limb, we readily observe the white cords termed nerves, and the substance of the limb, technically denominated muscles. Now, if we irritate either of these by means of a needle, or the galvanic current, we observe the muscles to contract: the nerves are excito-motor, the muscles are motor, organs. These principles of action are termed excitor in the nerve, irritability in the muscle, and both together are designated excitability,—that is, both are excitable under the impression of excitants. The nerves are diffused, 1, over the surfaces, and then the action is reflex; 2, in the muscular tissue, and then the action is direct. But what are the excitants of the living being ? These are principally air, oxygen, and food, to which heat, moisture,

is now on the decline. The eflloresis of a duller hue; the spots have more the character of stains than yesterday; and the patches on the neck are converted into rings; on the abdomen, chest, and thighs, the efflorescence is fading away, like ordinary roseola. The thin skin of the penis has a remarkable appearance, from its being, covered with deep rose-red stains. electricity, &c., are subsidiary. On Friday, and the two following days, the general sympExcitability in the living being-excitants in the surroundtoms improved, while the efflorescence continued to fade, and ing external world,-these, the reaction of these, such is on Monday he was sufficiently well to be re-vaccinated, and to life ;-these, the reaction of these in varied inverse ratiossuch is the source of the varied modes of life. All animated leave the hospital. The treatment of this affection is the same as that off Nature, from the monad to the condor, consists of these. But how is this play of the excitants upon the organs of common roseola-namely, mildly antiphlogistic at first,followed forms of animated or living being, by tonics. In the case which fell under my treatment, I pre- excitability, in the varied scribed gentian, with nitro-muriatic acid; the hospital case brought about ? That an egg, or a seed, exposed to warmth, or warmth and moisture, may be excited, may absorb oxygen, was treated with bark and sulphuric acid. may spring into life, is obvious enough. supposing them enUpper Charlotte-street, Fitzroy-square. .

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cence

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dowed

BIONOMIA; OR,

THE LAW OF LIFE.

BY &PHgr;I&Lgr;&Agr;&Lgr;&EEgr;&thgr;&EEgr;&Sgr;.

SECTION I. Lii?F is a creation, and none can comprehend its essence. It is the expression of the Divine will. Its laws alone can be

discovered.

respectively

with

excitability,

and the creative prin-

ciple of form, or of metamorphosis. But how do the more complicated forms of being become endowed with the actions by which air and food are taken into the system?-and how do these conspire and co-operate to form and maintain the living being, animal or plant?

Wonderful indeed are the forms and devices for effecting this object in the different and varied species of living being, and for so effecting this object as to maintain in its integrity, and in all its variations, the Law of Life.