Encyclopædia Medica, Vol. 5
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Produktbeschreibung
Excerpt from Encyclopædia Medica, Vol. 5: Herpes to Jaws It occurs in both sexes, and is generally stated to be most frequent between the ages of 3 and 20, the maximum incidence being between the ages of 12 and 13; but older people are by no means exempt, and in them the symptoms are apt to be severe. Although the disease often occurs in persons in robust health, general debility acts as a predisposing cause, as also - as first pointed out by Hutchinson - does arsenic when taken over long periods of time; but that arsenic is only an indirect cause is clearly shown by the small number who are affected out of the multitude who take the drug. Herpes zoster may be symptomatic, and, as such, is seen in certain diseases of the nervous system, as tabes dorsalis and myelitis; in the latter the eruption often corresponds to the upper level of the anæsthesia. Chronic peripheral irritation, e.g. caries of a rib or nerve injuries, will also sometimes give rise to attacks, which in such cases may be recurrent. The disease is probably of a specific nature, as shown by its acute onset, definite course, the infrequency of second attacks, and by the fact that it often recurs in distinct epidemics. Head considers it an acute inflammatory affection of the posterior root ganglia, analogous to that of the cells of the anterior cornua in acute anterior poliomyelitis. Symptoms and Course. - An attack of herpes zoster is usually ushered in with general feelings of malaise and a rise of temperature, which, in children, may reach 102° F.; superadded to these symptoms being acute pain and hyperæsthesia over the nerve area subsequently to be affected. In children the amount of pain may be slight or nil. The date of the appearance of the eruption is variable, but it usually appears at earliest two or three days after the first symptoms have shown themselves. The eruption appears first as an erythematous patch or patches, upon which numbers of small vesicles develop within a few hours. This outbreak follows the distribution of the nerve-fibres of the posterior roots, and is most intense where the main branches come to the surface, the patches being frequently oval, their long axis parallel to the subjacent nerve. The characteristic distribution is most typically shown in a case of intercostal herpes, in which one group of vesicles will often be seen near the spine over the spot where the posterior primary branch of the posterior root comes to the surface; another close to the axillary line over the site of the lateral branch of the anterior primary division; and a third group near the mid-line marking the termination of the anterior primary branch. There is no uniformity as to the order in which these maxima of intensity are affected, but as a rule the first patch to evolve is that nearest the nerve centre. The eruption is always most intense at these spots, and the intervals between them may or may not be filled up according to the severity of the attack. The right side is, curiously enough, much more commonly affected than the left. The corresponding lymphatic glands are almost always enlarged and tender, and may be so affected before the appearance of the eruption. The eruption may continue to appear in crops extending over a week, or even longer, or it may be fully developed in two days; in the former case it appears early in the disease, and its evolution is accompanied by persistent pyrexia and malaise; in the latter it usually denotes the termination of the pyrexial period, and may be regarded as a "critical" phenomenon. The initial lesions are erythematous patches, upon which papules and small vesicles rapidly form, which by coalescence may form comparatively large blebs. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.for
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