Selected monographs on dermatology / P.G. Unna [and others].

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs on dermatology / P.G. Unna [and others]. Source: Wellcome Collection.

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    it is transient in duration,1 and is not attended with, subjec- tive sensations or constitutional disturbances. The chloral rash is usually developed within a short time after commencing the use of the drug, rarely delayed longer than the tenth day. All observers have noted the fluxionary character of the hyperemia; indeed, one of the most cha- racteristic features of the eruption is the remarkable influ- ence of hot drinks or a full meal in its production. Always after the ingestion of food, tea, alcohol,2 &c, the rash becomes more intense and generalised. After suspension of the chloral even, the rash may continue to reappear for several days after each meal. The tendency to cutaneous irritation seems to remain latent until roused into activity by some stimulant to the vascular system. It then develops suddenly, remains out for a variable interval, one to two or three hours, and then vanishes, leaving no trace of its passage, except in some cases a slight furfuraceous desquamation. In other cases the rash may appear as an inflammatory redness, which is strikingly suggestive of the scarlatina exanthern, and may spread over the entire surface of the body. This similitude to scarlatina is rendered more exact by the increased sensitiveness of the skin, the high fever, and the more or less abundant desquamation which follows.3 Kobner reports a case in which there appeared not a simple hypei'aBmic redness, but an erythema exudativum which spread over nearly the entire surface. The skin was more swollen and infiltrated than in scarlatina, to which it tendency to flushing of the head and face. It is probably the condition referred to in some reports as erysipelas. The face flushing often com- mences in patches about the lips, cheeks, and forehead. In cases where the eruption is generalised over the trunk and limbs the face becomes uniformly flushed, and the conjunctivae and buccal and pharyngeal mucous membranes may be congested.—T. C. F. ' But, as in Bryant's case, may continue during the use of the drug.— T. C. F. 2 The influence of alcohol has attracted special notice from numerous writers. Barbillion drew attention to the occurrence, in infants taking chloral day by day, of a fleeting patchy rash when some spirituous prepara- tion of quinine, iron, &c, was added to the treatment. The ocular and buccal mucous membranes may be implicated.—T. C. F. i 3 The rash may be morbilliform (Saric and also Gontier, quoted by Bouju, Bryant, Middleton, &c.).—T. C. F.