Acute pemphigus : a contribution to the aetiology of the acute bullous eruptions / by George Pernet and William Bulloch.

  • Pernet, George.
Date:
[1896?]
Catalogue details

Licence: Public Domain Mark

Credit: Acute pemphigus : a contribution to the aetiology of the acute bullous eruptions / by George Pernet and William Bulloch. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    also from “ Nile Boils ” (boutons du Nil) which have left soars on his face. Has never had any other eruption. Previous to his illness, he had freely partaken of pork-butcher’s meat. During the whole of previous summer he suffered from pruritus, affecting the whole of the body. No malaise, no feverishness. The eruption of which he complains commenced on August 14th, the trunk, face, and root of limbs being affected. The Eruption.—When admitted, on August 18, there was a general pemphigus eruption, the bullae ranging in size from a millet-seed to a bean. Small bullae on the right eyelids. Bull® on the face, neck, chest (but fewer) ; in the axillae (con- fluent), on the buttocks, penis, thighs (few). A few bullae on the legs. None on the feet. Vesicles and confluent bullae about a recent scar over the metacarpo- phalangeal joint of the left middle finger. The bullae contain a clear, pale yellow fluid. No inflammatory areola. While he was being examined the patient complained of noises in the ears and dizziness. For three minutes he could not distinguish light. He was ultimately able to return to his bed in the ward. Temp. 37'8°. August 19.—Eyelids sticking together. On getting up in the afternoon: noises in the ears and dizziness. August 21.—An abundant crop of large tense bullse all over the body, with ex- ception of feet. On the abdomen and arms the bullse became confluent. Patient has not slept. August 22.—A fresh crop of bullse ; a few on the abdomen as large as a walnut. Half an hour after opening the bulls on the abdomen fresh ones made their appearance. These were tense, but not quite so large. August 23.—Fresh bullae. One on the nose as large as a large almond-shell. August 24.—Epistaxis lasting more than half an hour. Vomited several times. Scarcely any normal skin can be seen. Temp. 40°. Sub-delirium. Fetid odour. August 25.—Temp. 40-5°. No fresh bullae. Patient in greater pain. Great thirst. August 26.—Small crop of bullae on thighs. August 27.—Typhoid condition. Adynamia. Haemorrhagic bullae in different parts, especially on buttocks and knees. August 28.—Very weak. Temp. 38°. Pulse 120. Breath and smell from body very fetid. No fresh bullae. August 29.—Collapsed. Quiet delirium. August 30.—(Gibier gave up charge of patient to Brocq.) Pulse 120. Respira- tion 40. The eruption distinctly haemorrhagic. Diarrhoea. Tongue slightly dry. Red lymphatic lines about the bullse on lower limbs. Erysipelatous redness of forehead. August 31.—Death. Temperature.— The lowest temperature was 37-6° (August 21), and the highest 40-5° (August 25), falling to 39° (August 29). Urine.—A notable quantity of albumen found on August 20, also on 21st and 25th, less on 26th, and only a slight ring of albumen on 27th August. Post-mortem.—Thirty-six hours after death. Blood.—Diffluent, and saturating all the tissues. Brain.—Punctiform haemorrhages in the white substance, otherwise nil.