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HOPITAL DES ENFANS MALADES, PARIS.
503
word," "allow
me
for
a
moment," and
a
dozen other such ejaculations were uttered and persevered in for a most tedious period, the midst of which, and before any decision was arrived at, Dr. GREGORY, apparently for a moment fearful (we speak from the impression which the act was calculated to create in the mind of an observer) that the tide was going in a direction contrary to its desirable course, walked to the table, and put in a black ball (proclaiming the fact) " against the 8th resolution," which ball, by the result of the hurley hurley, actually reckonedagainst his own amend-
in
form, which the physicians designate by the term piquetée, and which in the outset may be readily taken for measles when the attention is confined solely to the cutaneous eruption, without a close examination of the premonitory symptoms. This error is the more likely to occur when scarlatina attacks (as we have often seen it do) a child already affected with cough, and occasion to notice
one
French
when the eyes are inflamed and watery from the commencement of the disease. The following case, though mild in its ment, for, finally, a good example of that The CHAIRMAN triumphed, and put the nature, presents form of scarlatina of which we have j nst amendment, which was declared to be again lost. He then put the original spoken: motion, when 31 balls appeared against Lebel, a boy, nine years of age, habi. it, and 21 were found in the opposite tually enjoying good health, and of sound drawer. A laugh having gone round the constitution, was seized on the evening of room, quiet was restored, and the discus- the 4th of October last with headach and sion of medical subjects was resumed. general malaise. During the night his throat became affected, and deglutition was accompanied with pain. On the followHOPITAL DES ENFANS MALADES, ing day the boy was seized with a violent shivering fit, which was quickly succeeded PARIS. intense fever with vomiting, excessive epistaxis, and some delirium at night ; there was no sneezing or coryza; the SCARLATINA. pain in the throat with the difficulty of THE tendency of eruptive diseases in deglutition became aggravated, and the childhood to reign at certain seasons of the eruption appeared on the evening of the when the child was brought to the year, epidemically, is known to every one; 5th, On- the morning of the 6th we hospital. but in hospitals appropriated solely to the found him in the following state: the face treatment of children there are some was moderately flushed ; the patient had which may be said to be endemic. Thus headach and intense fever; pulse 120 ; at the Enfans Malades of Paris there are the tongue was rather dry, and covered examples of scarlatina to be seen during with a white layer, through which a few the whole year ; the intensity and fre- red developed papillae were seen; deglutition was difficult, and on examining the quency of the disease are nevertheless mouth we found the back of the pharynx influenced considerably by the reign- covered with a red blush, and the amygingconstitution of the year, and by the dalæ considerably swollen; the voice was seasons. During the heat: of the present hoarse, as in the commencement of meabut there was no running from the summer scarlatina was very prevalcnt ; sles ; eyes, which were unaffected; the child the of the disease month August during did not cough, nor was there any diarlost much of its intensity, and has now rhoea, but constipation since the commencecompletely disappeared. However, the ment of his illness; the respiration was entrance of one patient into the hospital perfectly healthy; the skin was covered is almost sufficient to give rise to the de- with a multitude of small red points (scarlatine piquetee) in the intervals of velopment of the disease in others-a cir- which the integuments presented their cumstance which adds extremely to the natural colour; the eruption was closer, mortality which exists in those insti- and more abundant in the folds of the tutions, as the contagious principle in great articulations ; the joints of the hands most cases seizes upon children already and feet were neither swollen nor painful. reduced by other diseases. The common Borax, wit7i Honey;Emollient Clyster; low diet. forms of scarlatina are sufficiently familiar to all physicians, and the diagnosis is conIn the evening, at three o’clock, the sidered as easy,but we have had frequent character of the eruption became much
by
504
theuniform greater
The eruption of scarlatina is generally part of the redness; the described by writers as commencing by pulse was more feverish, and the tongue intense red patches, which quickly behad assumed decidedly the appearance come confluent on various parts of the to scarlatina.
better marked; skin presented
an
peculiar 7. To-day
the eruption is fully formed ; body ; but there are several varieties of the face more flushed ; the tongue has the disease which do not correspond ex. lost the white layer, become moist and red actly with this description ; one of these at the point and edges ; the redness is dif- is the scarlatine yiyuetce, an example of fused over the whole body, more marked which we have just given. In fact, when on the trunk and lower extremities, particularly on the inside of the thighs, where.we first saw the child Lebel, it was not it is evidently scarlatina; there is also a easy, from a mere inspection of the cuta. very great number of miliary vesicles on neous eruption, to decide whether it bethe abdomen, thighs, and arms ; the skinI longed to measles or scarlatina. The phy. is not very warm, and the pulse has fallen sician by whom the child was sent to the to 92 ; the pain in the throat and difficulty of deglutition continue; no pain of belly or hospital had diagnosticated rubeola, and head ; the child did not sleep during the some pupils, with the interne, at first in. night, but was not affected as before by clined to his opinion; however, in this delirium; he coughs a little to-day; had case, the premonitory symptoms were one stool after the injection; the hands sufficient to point out the true nature of are not swollen, but the ankle-joints are the affection ; the pain of the throat, slightly so, and stiff. of the amygdalae, and redness of Gum Julep ;Gargle of Barley Water and swelling the pharynx, coming on without coryza, Honey ;low diet. or affection of the mucous membrane, as 8. There was slight bleeding from the sneezing, lachrymation, &c., gave the disnose this morning; there is less pain of tinctive character of scarlatina, which the the throat, and the amygdalae are less swollen ; the tongue remains clean and progress of the disease in a few hours put red; the eruption has lost some of its in- beyond doubt. But we have had occasion tensity, but the miliary vesicles continue to observe several cases in which the prein the same state; but little thirst; the sence of symptoms, which are usually the child asks to eat; the pulse is 88, and forerunners of measles, have contributed tranquil; no stool. to throw much doubt and difficulty on the Gum Emulsion; Bouillon. diagnosis. Scarlatina sometimes com. 9. The eruption is fading away on the mences with excessive redness of the eyes, trunk and extremities; the skin is mode- lachrymation, swelling of the eyelids, rately warm ; pulse continues tranquil; sneezing, and the hard, hoarse, dry there is no pain of the throat, and the so peculiar to measles. Here it tongue is losing its redness; but the cough, short dry cough continues ; the child will be but prudent to wait until the erupsleeps well, and has a good appetite; one tion has assumed a decided character, stool. Cord. remedia. before we presume to give any opinion on 10. The scarlatina and miliary eruption its specific nature. Finally, scarlatina and have both nearly faded away; desquamameasles may attack the same individual tion commences, and there is a smart sensation of itching in the skin; the cough at the same moment, and both eruptions has diminished, and become more soft; may run their course together. Of this respiration gives a healthy sound to interesting fact, which has been denied auscultation; no fever or diarrhoea; the by Underwood and many other writers on child sleeps well. diseases of children, we shall at anGum Emulsion with Manna; Bouillon. other time report several examples.
I
the
11. Convalescence may be said to have
commenced ; there is no pain or redness of the throat; the pulse natural, 70. The
We have been favoured by Professor of Oxford, through the hands of detaching from the neck and OGLE, i.EY, of Fore street, with copy of the document limbs in large flakes, accompanied with entitled " De Tempore ct Excrcitiis requisins ad smart The child continued itching. very Gradus in Medicina Capessendos," which has just
epidermis
is
in this favourable state to the l8th of October, when he was dismissed the hos.
pital.
a
been issiletl
by the University
of Oxford. We have
publication this week. Dr. Turnbull’s letter in our next.
xot
room
fur its
word," "allow
me
for
a
moment," and
a
dozen other such ejaculations were uttered and persevered in for a most tedious period, the midst of which, and before any decision was arrived at, Dr. GREGORY, apparently for a moment fearful (we speak from the impression which the act was calculated to create in the mind of an observer) that the tide was going in a direction contrary to its desirable course, walked to the table, and put in a black ball (proclaiming the fact) " against the 8th resolution," which ball, by the result of the hurley hurley, actually reckonedagainst his own amend-
in
form, which the physicians designate by the term piquetée, and which in the outset may be readily taken for measles when the attention is confined solely to the cutaneous eruption, without a close examination of the premonitory symptoms. This error is the more likely to occur when scarlatina attacks (as we have often seen it do) a child already affected with cough, and occasion to notice
one
French
when the eyes are inflamed and watery from the commencement of the disease. The following case, though mild in its ment, for, finally, a good example of that The CHAIRMAN triumphed, and put the nature, presents form of scarlatina of which we have j nst amendment, which was declared to be again lost. He then put the original spoken: motion, when 31 balls appeared against Lebel, a boy, nine years of age, habi. it, and 21 were found in the opposite tually enjoying good health, and of sound drawer. A laugh having gone round the constitution, was seized on the evening of room, quiet was restored, and the discus- the 4th of October last with headach and sion of medical subjects was resumed. general malaise. During the night his throat became affected, and deglutition was accompanied with pain. On the followHOPITAL DES ENFANS MALADES, ing day the boy was seized with a violent shivering fit, which was quickly succeeded PARIS. intense fever with vomiting, excessive epistaxis, and some delirium at night ; there was no sneezing or coryza; the SCARLATINA. pain in the throat with the difficulty of THE tendency of eruptive diseases in deglutition became aggravated, and the childhood to reign at certain seasons of the eruption appeared on the evening of the when the child was brought to the year, epidemically, is known to every one; 5th, On- the morning of the 6th we hospital. but in hospitals appropriated solely to the found him in the following state: the face treatment of children there are some was moderately flushed ; the patient had which may be said to be endemic. Thus headach and intense fever; pulse 120 ; at the Enfans Malades of Paris there are the tongue was rather dry, and covered examples of scarlatina to be seen during with a white layer, through which a few the whole year ; the intensity and fre- red developed papillae were seen; deglutition was difficult, and on examining the quency of the disease are nevertheless mouth we found the back of the pharynx influenced considerably by the reign- covered with a red blush, and the amygingconstitution of the year, and by the dalæ considerably swollen; the voice was seasons. During the heat: of the present hoarse, as in the commencement of meabut there was no running from the summer scarlatina was very prevalcnt ; sles ; eyes, which were unaffected; the child the of the disease month August during did not cough, nor was there any diarlost much of its intensity, and has now rhoea, but constipation since the commencecompletely disappeared. However, the ment of his illness; the respiration was entrance of one patient into the hospital perfectly healthy; the skin was covered is almost sufficient to give rise to the de- with a multitude of small red points (scarlatine piquetee) in the intervals of velopment of the disease in others-a cir- which the integuments presented their cumstance which adds extremely to the natural colour; the eruption was closer, mortality which exists in those insti- and more abundant in the folds of the tutions, as the contagious principle in great articulations ; the joints of the hands most cases seizes upon children already and feet were neither swollen nor painful. reduced by other diseases. The common Borax, wit7i Honey;Emollient Clyster; low diet. forms of scarlatina are sufficiently familiar to all physicians, and the diagnosis is conIn the evening, at three o’clock, the sidered as easy,but we have had frequent character of the eruption became much
by
504
theuniform greater
The eruption of scarlatina is generally part of the redness; the described by writers as commencing by pulse was more feverish, and the tongue intense red patches, which quickly behad assumed decidedly the appearance come confluent on various parts of the to scarlatina.
better marked; skin presented
an
peculiar 7. To-day
the eruption is fully formed ; body ; but there are several varieties of the face more flushed ; the tongue has the disease which do not correspond ex. lost the white layer, become moist and red actly with this description ; one of these at the point and edges ; the redness is dif- is the scarlatine yiyuetce, an example of fused over the whole body, more marked which we have just given. In fact, when on the trunk and lower extremities, particularly on the inside of the thighs, where.we first saw the child Lebel, it was not it is evidently scarlatina; there is also a easy, from a mere inspection of the cuta. very great number of miliary vesicles on neous eruption, to decide whether it bethe abdomen, thighs, and arms ; the skinI longed to measles or scarlatina. The phy. is not very warm, and the pulse has fallen sician by whom the child was sent to the to 92 ; the pain in the throat and difficulty of deglutition continue; no pain of belly or hospital had diagnosticated rubeola, and head ; the child did not sleep during the some pupils, with the interne, at first in. night, but was not affected as before by clined to his opinion; however, in this delirium; he coughs a little to-day; had case, the premonitory symptoms were one stool after the injection; the hands sufficient to point out the true nature of are not swollen, but the ankle-joints are the affection ; the pain of the throat, slightly so, and stiff. of the amygdalae, and redness of Gum Julep ;Gargle of Barley Water and swelling the pharynx, coming on without coryza, Honey ;low diet. or affection of the mucous membrane, as 8. There was slight bleeding from the sneezing, lachrymation, &c., gave the disnose this morning; there is less pain of tinctive character of scarlatina, which the the throat, and the amygdalae are less swollen ; the tongue remains clean and progress of the disease in a few hours put red; the eruption has lost some of its in- beyond doubt. But we have had occasion tensity, but the miliary vesicles continue to observe several cases in which the prein the same state; but little thirst; the sence of symptoms, which are usually the child asks to eat; the pulse is 88, and forerunners of measles, have contributed tranquil; no stool. to throw much doubt and difficulty on the Gum Emulsion; Bouillon. diagnosis. Scarlatina sometimes com. 9. The eruption is fading away on the mences with excessive redness of the eyes, trunk and extremities; the skin is mode- lachrymation, swelling of the eyelids, rately warm ; pulse continues tranquil; sneezing, and the hard, hoarse, dry there is no pain of the throat, and the so peculiar to measles. Here it tongue is losing its redness; but the cough, short dry cough continues ; the child will be but prudent to wait until the erupsleeps well, and has a good appetite; one tion has assumed a decided character, stool. Cord. remedia. before we presume to give any opinion on 10. The scarlatina and miliary eruption its specific nature. Finally, scarlatina and have both nearly faded away; desquamameasles may attack the same individual tion commences, and there is a smart sensation of itching in the skin; the cough at the same moment, and both eruptions has diminished, and become more soft; may run their course together. Of this respiration gives a healthy sound to interesting fact, which has been denied auscultation; no fever or diarrhoea; the by Underwood and many other writers on child sleeps well. diseases of children, we shall at anGum Emulsion with Manna; Bouillon. other time report several examples.
I
the
11. Convalescence may be said to have
commenced ; there is no pain or redness of the throat; the pulse natural, 70. The
We have been favoured by Professor of Oxford, through the hands of detaching from the neck and OGLE, i.EY, of Fore street, with copy of the document limbs in large flakes, accompanied with entitled " De Tempore ct Excrcitiis requisins ad smart The child continued itching. very Gradus in Medicina Capessendos," which has just
epidermis
is
in this favourable state to the l8th of October, when he was dismissed the hos.
pital.
a
been issiletl
by the University
of Oxford. We have
publication this week. Dr. Turnbull’s letter in our next.
xot
room
fur its