A Text-Book of Surgery Volume 2 (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1897 Excerpt: ...in the muscular fibres themselves. There is also a slight interstitial inflammation of the nerves. The central nervous system is intact (Hochhaus). Secondary diphtheria of the skin in cases of severe diphtheria of the throat is also of special interest. This is found only in those parts of the outer skin which have lost their epidermis, as in intertrigo and eczema of the inguinal fold and in wounds of the skin. In rare cases the reverse is true--that is, secondary diphtheria of the throat has been known to follow this primary diphtheria of the skin. Finally, there appear in the course of diphtheria various forms of eruption, which are, for the most part, of serious prognostic significance. When diphtheria is attended with changes in the skin--e. g., with dark-red or bluish-green petechia?, with erythema, or, what is less frequent, a papular eruption, with spreading ulcers arising from small hemorrhagic, varicella-like vesicles (Riehl), etc.--it almost always ends fatally. Inasmuch as streptococci so often appear in diphtheritic foci, it is easy to understand why diphtheria is sometimes complicated by erysipelas of the mucous membrane, and especially of the skin (Leyden, Renvera). With reference to other forms of diphtheria, complicating scarlet fever and measles, for example, the reader is referred to text-books on internal medicine. If diphtheria ends in recovery the necrotic tissue is cast off, the infiltration is absorbed, and the defect thus made is healed with a corresponding cicatrix. The layers of exudate are gradually displaced by the succeeding healthy epithelium. If a diphtheritic membrane comes away in t-t, this is due to the elasticity of the coagulated substance. Cicatrices are left especially after deep and extensive necrosis. Death resul...