A manual of medical diagnosis / by A.W. Barclay.

  • Barclay, A. W., 1817-1884.
Date:
1857
Catalogue details

Licence: Public Domain Mark

Credit: A manual of medical diagnosis / by A.W. Barclay. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    57G cmst may not be quite cbaracteristic. In impetigo this difficulty is most likely to be met with, because its characters vary as the disease is spread over a large surface in solitary pustules, called irnjJetigo s})arsa, or is limited to distinct patches, when the namQ Jigurata is applied to it. In the former the single pustules have at first much the appeai’ance of vesicles, but they very soon lose their transparency : among vesi- cular diseases we have found no such example except scabies; and therefore, when a case of this kind is met with, the question cannot be, is it eczema which exists only in patches, or herpes whicli forms small and well- defined groups, but whether it be scabies or impetigo : the answer is only to be obtained from the diagnosis of scabies. When, again, the eruption occurs in patches it is more liable to be mistaken for herpes : but the course of the two diseases is quite different; the one commences suddenly, and is preceded by irritation, the other is gradual, and its begimiing is unobserved ; the one terminates in a few day.s, the other lingers on for weeks or months. The common history of impetigo is that, after some decree of redness and tumefaction of the skin, one or more distinct pustules slowly make their appearance, the irritation which accompanies them being so slight as to escape observation in most instances, and the eruption itself receiving little attention. The matter contained in them very soon becomes decidedly pu- rulent and forms a firm scab; but before those first observed have had time to dry up, others appear in succession, which are either scattered and distinct, or in close proximity to the former. It is scarcely possible to say in the first instance which of the two varieties is likely to be developed. ■\\Hien the disease has already lasted some time, and a thick crust has formed, it matters little whether it he called eczema impetiginodcs or impetigo,—herpes it cannot be; for the only question worth comsidering is, whether there be any appearance of redness or tendency to spread about its margin. The crusts of