Some aspects of lymphadenoma (Hodgkin's Disease) / by H.D. Rolleston.

  • Rolleston, Humphry Davy, Sir, 1862-1944.
Date:
[1911?]
Catalogue details

Licence: In copyright

Credit: Some aspects of lymphadenoma (Hodgkin's Disease) / by H.D. Rolleston. Source: Wellcome Collection.

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    variation in different cases. Three distinct types of fever were originally described by Sir William Gowers26; these types are :—(i) a persistent mild fever—usually ioi° to io2° F. with a daily variation of a degree and a half only ; this may continue for months. (ii) ' Fever characterised by a high irregular temperature with morning remissions to ioo° F. ; this form is usually seen in the later stages and may be accompanied by sweating and chills. The temperature imitates that of suppuration and in cases with hepatic enlargement may strongly suggest abscess. (iii) A relapsing form of temperature characterised by alternating periods of fever and of a normal temperature ; the duration of the febrile period is usually from 5 to 15 days and of the non-febrile period about the same; but there are considerable variations, perhaps due to the combination of this form of fever with one of the two previous forms. This type is so remarkable that it has been the subject of numerous papers (Pel,27 Ebstein,28 Fischer,29 Musser,30 F. Taylor,31 H. B. Shaw,32 J. Phillips33). Ebstein regarded it as a new infectious disease and called it “ chronic relapsing fever,” and Pinkus spoke of it as “ Ebstein’s disease ” ; but it is now recognised as being a com¬ plication of lymphadenoma, as indeed Murchison34 described it in 1870. During the febrile attacks the glands and spleen commonly enlarge and become tender, whilst they recede in the non-febrile periods. In a case under my care jaundice corresponded to the febrile periods and was probably due to enlargement of the glands in the portal fissure. The skin over the glands may get red, and transient dilatation of the heart has been noted during the paroxysms. In the intervals an unusual appetite has been recorded. The febrile periods are accompanied by much constitutional disturbance. This relapsing fever has been known to go on for a year (Taylor, Westphal), or even 14 months (Fischer) ; 26 Gowers: System of Medicine (Russell Reynolds), 1879, V. 27 Pel: Berlin, klin. Wchnschr., 1885, XXII., 3 ; 1887, XXIV., 644. 23 Ebstein : Ibid., 1887, XXIV., 565, 837. 23 Fischer : Deutsche Ztschv. f. Chir., Leipz., 1893, XXXIV., 233. 30 Musser: Trans. Xssoc. Amer. Phys., 1901, XVI., 638. 31 Taylor, F.: Guy's Hosp. Rep., Fond., 1906, FX., 1. 32 Shaw, H. B.: Edin. Med. Journ., 1901, N.S., X., 501. (References.) 33 Phillips J.: Cleveland Med. Journ., 1910, IX., 604. 34 Murchison: Trans. Path. Soc., Fond., 1870, XXL, 372.