Re: Help with case of suspected ringworm - LONG
Posted: Sun Aug 21, 2005 11:42 am
by tjelie
Hi Barbara
I was reading about the skinsymptoms of Rhus venenata and it did
remind me of the case you wrote about.
Annemieke
Allen, Encyclopaedia of Pure Materia Medica
Rhus venenata, D.C. (Rhus vernix, Linn, in part.).
Natural order, Anacardiaceae.
Common names, Poison elder, Swamp sumach, etc.
Preparation, Tincture of the leaves and stems
Skin
- Nocturnal itching, and an affection very much like erythema
nodosum; there had appeared red spots, varying from a half to two
inches in diameter, especially on the legs, below the knee; these
pained her, and underwent all the changes as if caused by a fall or
blow, namely, the red changed into a bluish, then greenish-yellowish
color, leaving finally spots of a little darker tint than the
healthy skin; of these there were several, but in different stages,
[a17].
- A very distressing cutaneous disease, it is well known, ensues in
many persons from the contact, and even from the effluvia of this
shrub. It is extremely various in its action upon persons of
different idiosyncrasies; some cannot come within the atmosphere of
the shrub without suffering the most violent consequences, others
are but slightly affected by handling it, and some can even rub,
chew, and swallow the leaves without the smallest inconvenience; the
most formidable cases in persons subject to this poison usually
commence within twenty-four hours after the exposure; the interval
is sometimes longer, but more frequently shorter; the symptoms are
generally ushered in by a sense of itching and a tumefaction of the
hands and face, the swelling gradually extends over various parts of
the body, assuming an erysipelatous appearance; the inflamed parts
become more elevated, acquiring a livid redness, attended with a
painful burning sensation; small vesicles now appear upon the
surface, which extend and run into each other; they contain a
transparent fluid, which by degrees becomes yellow, and at length
assumes a purulent appearance; a discharge takes place from these
vesicles or pustules, puruless, giving rise to a yellowish
incrustation, which afterwards becomes brown; in the mean-time an
insupportable sensation of itching and burning is felt; the inflamed
parts become excessively swollen, so that not unfrequently the eyes
are closed, and the countenance assumes a shapeless and cadaverous
appearance, which has been compared to that in malignant small-pox;
the disease is usually at its height from the fourth to the sixth
day, after which the skin and incrustations begin to separate from
the diseased parts, and the symptoms gradually subside; it is not
common for any scars or permanent traces of the disease to remain;
notwithstanding the violent character which it sometimes assumes, I
never knew an authenticated case of its terminating fatally; it is,
however, capable of occasioning the most distressing symptoms. I
apprehend the majority of persons are not liable to the injurious
effects of the poisonous sumachs; in those in whom a constitutional
liability to the poison exists, the disease frequently returns
several times during life, notwithstanding the utmost precaution in
avoiding its causes. A gentleman, residing in the country, informed
me that he had been seven times poisoned to the most violent degree;
in such constitution a slight exposure is sufficient to excite the
disease. I have known individuals badly poisoned in winter from the
wood of Rhus vernix accidentally burnt on the fire, [a5].
- The cellular tissue is greatly swollen, of a deep-red color, and
covered with watery vesicles, that itch most intolerably, [a15].
- Small itching vesicles, that burst and healed, with desquamation
and moderate redness; after repeated application to the desquamating
spots, the skin became intensely red, and large blisters formed and
filled with lymph; this afterwards changed to matter, and
disappeared by the formation of a scab only after three weeks,
[a13a].
- Red indurated elevations on various parts of the body, especially
on the face, neck, and chest, [a7].
- The result was a small moist scab, with the characteristic burning
itching, but it lasted only a day or two, [a19a].
- Desquamation took place three different times from all the parts
affected with the vesicular eruption, [a15].
- Itching, with red spots on the skin (twenty-first day), [a13].
- Redness and swelling of the skin of the forehead, eyelids, nose,
cheeks, lips, and ears, behind the ears, and on the front of the
neck; the skin of these parts is covered with minute lenticular
vesicles, which are filled with serum. These vesicles seem to be
situated in the rete mucosum, at least they involve a deeper tissue
than the cuticle. During the day, some of them find their way to the
surface and are ruptured while being scratched (third day).Same
symptoms, with increased violence (fourth day), [a10].
- Erysipelas of the head and face, [a15].
- A number of boils came out on my forehead, neck, and arms after
proving the Rhus v., [a15].
- Clusters of vesicles behind the left ear, [a7].
-On rising, oedema under the right eye, difficulty in looking down,
with disagreeable sensation; red spot on the face, especially on the
left side and on the upper part of the chest, itching; in
consequence of the oedema, the eye is somewhat sensitive when
reading or writing, but causes no difficulty in looking straight
forward; during the day the face swollen (thir day). A round group
of hydroa vesicles, filled with yellowish serum, between the nose
and the left corner of the mouth, and another group under the
latter; left side of the face somewhat swollen and covered with red
spots; left ear thick and red, posterior surface of it rough; some
itching on the lower part of the ear; the nose and right side of the
face considerably swollen, especially close under the eye, so much
so that the cilia of the lower lid lie on the swelling, and the eye
appears very small; the eye considerably irritated; the rays of the
sun cause burning in the face; much itching of the sexual organs,
especially upon the scrotum and praeputium; hydroa vesicles on the
back of the first and third fingers of the left hand and of the
second finger on the right hand; at 2 P.M. , small yellowish hydroa
vesicles on different parts of the face; the right side of the nose
and right cheek much swollen, the oedema of the face worse than
yesterday; the skin rough (not chapped) and uneven; on the back of
the left hand and on the fingers some efflorescence, which looks
strikingly like itch; rubbing the affected parts causes itching; at
3 P.M. an eruption, like measles, with unevenness of the skin on the
back of the left arm, close above the wrist, soon followed by
blotches, with violent itching and burning; face hot; in the evening
much itching and burning on different places in the face. At night,
much itching on the face and sexual organs, especially on the
praeputium; the skin on the scrotum inflamed and thickened; very
violent burning and itching on the left cheek, soon followed by the
whole face becoming so burning hot that I had to leave the bed and
wash the face in cold water (fourth day). At rising, much burning on
the hands, especially between the fingers, which are somewhat
swollen, the itchlike eruption on the back of the left hand and on
the fingers, which disappeared last evening, has reappeared and
disappeared several times during the day; the hydroa vesicles on the
back of the third finger larger than yesterday; the right side of
the face the same as last evening, the left worse, more swollen, and
inflamed; much itching and burning on the latter, also behind the
ears, which are swollen, inflamed, and rough (not chapped); the
attacks of itching, burning, and inflammation show the same
irregular periodicity as in the first proving, and are also followed
by an eruption of blotches, vesicles, and red spots, and are
produced and increased by the same causes; the general result of
this proving much the same as of the first (fifth day). The right
side of the face nearly well; the left better than yesterday, but
still much itching on the lower part of the left cheek and on the
back of the left ear; in the face, desquamation of the parts which
have been most affected; the hands worse than yesterday; the
itchlike eruptions on the backs of the hands and on the fingers (at
times violently itching) worse and more numerous than at any
previous day; itching upon the sexual organs; four small pimples,
filled with pus, on the face (sixth day). On waking, violent itching
between the fingers; on the face but little inflammation and
itching; the desquamation more extensive than yesterday; the back
part of the left ear still rough; the hands worse than yesterday;
the skin rough (seventh day). At 2 P.M. the lower part of the
cheeks, especially the right, swollen, inflamed, violently burning,
and covered with blotches; on the back of the hands and between the
fingers, often violent burning and itching; between the metacarpal
bones of the left thumb and first finger, the skin inflamed and
swollen; erythema on the right side of the neck, extending to the
chest; itching on the scrotum and praeputium (eighth day). At 2 A.
M. severe itching on the hands, particularly between the fingers, so
that I had to put them in cold water; on the whole, symptoms much
like yesterday, namely, periodical inflammation, swelling vesicles,
red spots, blotches, itching and burning on the face, ears, neck,
and hands; this morning, little red spots and itching on the inside
of the thighs; the itchlike affection on the hands has spread from
two to three inches above the wrist, worse on the left (ninth day).
The last three mornings, at rising, an attack of itching on the
hands; the various symptoms very gradually subsiding; desquamation
on the face (twelfth day). The little scabs, formed from the hydroa
vesicles on the fingers, fell off to-day; much itching on various
parts of the body (thirteenth day).Desquamation on the fingers; it
commenced simultaneously on different parts, and spread in circles
or rings, some of these are confluent to-day, which causes an
indented appearance of the desquamation (seventeenth day). The
desquamation on the back of the hands and fingers is just completed,
and is now spreading into the palm of the hand; the nocturnal
itching has occurred but three or four times since the seventeenth
day, and during the last fourteen days scarcely any itching, not
even at night (thirty-fifth day). On the tenth day I had touched
quickly, several times, the eruption of urticaria with freshly
picked stinging-nettles, and felt distinctly the burning sensation
of their touch; very soon a new eruption of urticaria appeared, and
the old (primitive) eruption disappeared as fast as the new one
came; at the same time the itching of the old blotches decreased,
while that of the new ones increased; this I perceived very
distinctly; the old eruption disappeared after the lapse of ten or
fifteen minutes, the new one after about half an hour. I repeated
this application the following days, and must attribute to this
treatment the fact that from this time I suffered less than I
expected, judging from the experience of the first proving; the
nocturnal itching was particularly much less, and of much shorter
duration, [a16a].
- A day or two afterwards the poison began to manifest itself,
eruption that produced by Rhus tox. in provings, the corners of the
mouth being in a scab; itching unbearable; Rhus tox. 2e was given.
Four days later the eruption is much worse; cannot sit still; has to
scratch himself continually; warm applications relieve; gave him
Rhus venenata, second centesimal, two drops every three hours, and
continued warm application; in twenty-four hours some relief; in
forty-eight hours great relief; in seventy-two hours great relief;
in seventy-two hours itching entirely gone, and eruption disappeared
from genitals and thighs; in five days hands are well, and scabs
come off of face; feels comfortable; in eight days, skin all peeling
off on face where scabs were and poison apparently almost entirely
removed from his system, [a23].
-Swelling of the face, with red spots and indurations constantly
itching and burning after rubbing, [a7].
- My face, and particularly my upper lip, were much swollen and
exceedingly painful; the backs of my ears were swollen and covered
with vesicles; both these and those on my lip exuded a slightly
yellow serum, and they went through the same course as the other
eruptions, [a12].
- The face was mottled with red; the redness was not dissipated by
pressure of the finger, [a7].
- The face is very dry and rough and has a scurfy appearance, and
the skin seems to be thickened and indurated (seventh day), [a10].
- Eruption on the face, head, and chest, resembling the rash of
typhoid fever, disappearing on pressure, [a19b].
- Next day a slight itching of hands and lips; second day, itching
of hands and body, as well as face; face swollen; eruption on corner
of mouth, [a21].
- Lips feel uncomfortable (first night); much swollen in the morning
(second day); lips peeling off; vesicles on lips and face emitting
an odor similar to a sore (third day), [a20a].
- On rising, mouth and lips dry; lips sore and swollen, blistered
and cracked; it is impossible to keep the mouth moist, getting
easier one hour afterwards, but coming on again and lasting all day;
itching of upper lip and chin at 4 P.M. ; at 6 P.M. , lips and mouth
become more feverish; at 8 P.M. , lips painfully hot and dry; cannot
get them cool; they burn constantly (third day). On waking,
uncomfortable feeling in mouth and lips; lips painful, dry, and
swollen to double their natural size; white vesicle on lower lip; at
8 P.M. , lips and tongue feel as if cracked; lips swollen, the upper
one the worse; itching in corner of mouth (fourth day), upper lip
more swollen than lower lip; lips and tongue feel as if cracked;
lips peel off somewhat; they burn and itch considerably when washing
(fifth day). Lips worse than ever; upper one most affected; lips
black on edges; yellow vesicles on inner side of lips, which break,
discharging a thin sticky fluid, agglutinating them together (12
P.M. ); lips hot and dry and burning, aggravated by washing in cold
water or touching them with tongue, or when eating anything sour;
cream applied to the lips relieves the burning sensation, but hot
applications ameliorate more than all (sixth day). Lips swollen and
covered with a thick skin or crust, that in breaking emits an
offensive discharge, resembling that from a sore, thin and sticky;
warm water makes them feel comfortable and pleasant; acid food hurts
his lips (seventh day). Lips are better, but still smart a good deal
when touching acids; relieved by hot water; inside of lips filled
with little white vesicles (eighth day). Lips improving (ninth
day).Seem all right (thirteenth day), [a20].
- Next day I was completely poisoned, and the symptoms ran a course
similar to that of the first proving, the itching being worse on the
hands, genitals, anus, lips, mouth, and nose; hot water afforded
great relief, and Clematis erecta 2e cut the disease short, but did
not prevent the skin peeling off the hands, [a20b].
- During the day the itching in the face has increased and spread
over the nose, the edges of the nostrils, the upper and lower lips,
the external ears, and the inferior portion of the neck immediately
above the sternum and clavicles; the skin on these parts feels
rough, and is covered with a minute eruption of lenticular vesicles,
filled with transparent serum; itching on the back of the hands,
particularly between the fingers. The itching on the scrotum and
prepuce has become more troublesome, and is much increased by
sratching; scratching or rubbing of the parts is followed by intense
burning (second day), [a10].
- I felt no unpleasant effects for six or seven hours after
returning to Boston; about 8 P.M. I perceived the backs of my hands
were swollen and puffy, but without pain or itching; my forehead and
upper lip were soon in the same state. On the next morning the
tumefaction had increased, and I discovered various other parts of
my body to be infected; the backs of my hands and wrists, which were
the most advanced, began to show small watery vesicles; at noon I
applied cloths dipped in lead water to one hand and wrist, and in a
spirituous solution of the corrosive muriate of mercury to the
other, the parts began to itch, the tumefaction increased,
vesication began to take place on the swollen surface, small
pustules formed and ran into each other, and at last some were
formed as large as nutmegs. On the third day my eyes were nearly
closed, in consequence of the swelling of my forehead, eyebrows, and
cheeks; the contents of the vesicles were perfectly limpid;
inoculation from them to other parts had no effect neither in this
nor any subsequent stage. On the evening of the fourth day the
inflammation appeared at its height; the burning sensation and
itching were intolerable; I could scarcely discern any object. On
the fifth day the pustules began to appear a little milky, and
before night the inflammation was evidently on the decline. On the
sixth day a very free desquamation began, first on my forehead,
hands, and wrists. In just a fortnight I was able to leave my
chamber, blessed with a new cuticle from the root of the hair on my
forehead to my breast, from the middle of my forearm to the tips of
my fingers, and on the whole inside of my thighs. After nine months,
still subject to an eruption of watery pustules between my fingers,
which dry up and the cuticle peels off, [_a3].
- In one hour and a half I began to feel a most intense itching and
burning of the scrotum and penis; the burning sensation was rather
in the preponderance; the glans penis was very painful; slight
friction relieved the itching for a moment, but not the burning
(first day). The symptoms continued in the same severity; at 3
P.M. , itching and burning commenced on the back of my right hand,
between the thumb and index finger, also between the index and
middle fingers (second day). Awoke this morning with itching and
burning in various parts of the body, particularly on the palmar
sides of both wrists attended with slight swelling; slight itching
and burning of the face, with a sensation as if it was much swollen;
it was red, but not shining. Both hands were considerably swelled
and very clumsy to use. Feeling of uneasiness in consequence of the
continual itching and burning, which were very severe, almost
insupportable; P.M. , the itching and burning were somewhat relieved
by exercise; the burning and itching appear on the face,
particularly about the eyes (right); all the symptoms were
aggravated by rest. Hands, wrists, and face became covered with
little pimples of the same color as the skin; when broken, or the
points are scratched off, they exude a clear watery fluid. Fingers
are very stiff and much swollen; feel very much as though they had
been scalded; excessive burning of face; right eyelid swollen and
stiff; the scrotum is the seat of paroxysms of severe itching and
burning (third day).Symptoms all increased; face much swollen, red,
covered with multitudes of little papillae; wrists much swollen, the
swelling extending half way to the elbow; arms very red and covered
with innumerable vesicles, which exude a clear watery fluid; hands
in same condition; the pain was excessive (fourth day). Hands and
wrists much worse this morning; face much swollen; the itching and
burning continues with unabated vigor, and are aggravated by the
warmth of the bed and in a warm room; in the evening, hands and
wrists are still more swollen and excessively painful; face a little
less swollen and rather less painful; incrustations appeared to-day
on the inside of my thighs, extending down one-half the length of
the femur. A feeling as from fleabites on different parts of the
body (fifth day). Hands and arms still very sore, but not so much
swollen; the exudation is now light-yellow (sixth day). The swelling
of the arms and hands continues to abate; the cuticle now scales off
at those places which first broke out with vesicles; the
desquamation was excessive, as the cuticle peeled off some four
times in succession from the places that had been covered with
vesicles; after the cuticle came off, the first appearance of the
skin was red and shining, but after getting my hands damp, several
cracks (like those of chapped hands) appeared in different places;
my hands became exceedingly rough, the cuticle being dry and hard,
also very tender, so that the least bruise was very painful, and if
the skin was broken, the blood flowed freely, which was very thin,
or if you please, anaemic (after six days), [a12].
- I often scratched my neck under my shirt-collar during the day,
and on getting warm in bed I felt stinging and itching about my
chest and back, as though some insect was biting me (ninth day).
Forehead swollen and red, in the morning; during the day this
extended to the whole head and face; the upper lip was terribly
swelled and the itching greatly increased, especially in the septum
narium; the itching extended to the whole body; though no eruption
appeared; at night the itching was so great that I could hardly
endure it; I passed a sleepless night (tenth day). The vesicular
eruption characteristic of Rhus showed itself on the forehead in the
morning; during the day the eruption spread over the body and
extremities, with a desire to scratch that was irresistible; the
scrotum, prepuce, and glans penis covered with vesicles (twelfth
day). The itching continued more than two weeks, [a14].
- The scrotum is very much swollen, of a deep-red color, and covered
with vesicles, [a15].
- Back becomes covered with blotches; itching is excited or brought
on by exposure to cold air; gentle scratching relieves the burning
and itching, on the back; later, the blotches disappear, the back
becomes covered with ridges, and a fine pale-red rash appears
(second day). Itching on back is brought on in a moment by cold air
blowing on it (second night), [a20a].
- Pimples like commencing boils on the scapulae and neck
(seventeenth day), [a13].
- (Part 1 of 11) Twenty-four hours after the first application of
the juice, I perceived a this part there was slight soreness,
apparently near the bone; these symptoms increased steadily but
slowly during the next eleven days, with occasional itching and
burning on the place of application. On the fourteenth day the arm
presented the following appearance : The epidermis, on the place of
the application, can be easily removed with the finger nail, and
then little scabs form in a short time; the whole place inflamed,
very much swollen, and red, almost three inches broad, and a little
more than three and a half inches long; the centre redder and harder
than its surroundings; a fold of the skin on the affected part at
least six times thicker than one on a corresponding place on the
other arm; when uncovered there is little itching and burning, but
very violent when covered by the shirt-sleeve (linen); slight
rubbing causes a pleasant sensation, a kind of satisfaction;
scratching is painful, but both increase the itching and
inflammation; a slight impression only is produced by severe
pressure with the finger; the redness is not circumscribed, but
passes over into an eruption, like measles; the arm measures on the
affected place, in circumference, almost an inch more than the other
arm; the surrounding parts of disease.
- (Part 2 of 11) On the sixteenth day, at dawn, I was awakened by
violent itching; the swelling is five and a half inches long;
considerable oedema, especially on the side of the ulna, and a half
inch above the affected part; when covered by the shirt-sleeve, very
violent itching; on scratching, I removed a part of the epidermis,
which was followed by a secretion of a little serum and a very slow
formation of scabs; the remaining epidermis, for the last two or
three days, adheres closer than before.
- (Part 3 of 11) On the seventeenth day I was awakened at 3.30 A. M.
by a violent itching and burning, the arm looking very much worse;
presented the appearance of a severe phlegmonous inflammation; the
part affected has a livid color, and the inflammation extends from
two to three inches each way, so that the whole inflamed part is six
and a half inches long and six inches wide; the inflammation is not
circumscribed, but passes over into an eruption, like measles, which
varies from one-half to two inches in width; the inflamed skin feels
very hot, and is (though uncovered) eight and a half degrees warmer
than the corresponding place on the other arm (I held the
thermometer on the arm, slightly pressing, but without covering it);
small scabs of dried serum on the inflamed surface; the swollen part
of the arm is hard, like board, but without pain; after dinner,
disagreeable drawing sensation in the arm, extending into the hand,
and a feeling of tightness; towards evening, reappearance of the
pain; the swelling and inflammation increased through the day in
violence and extent, towards the elbow, a whole inch, not so much in
other directions; the nerves in the armpit sore and sensitive to
pressure; late in the evening, red irregular spots on the left
cheek.
- (Part 4 of 11) On the eighteenth day the swelling extends from the
elbow to the hand; the the skin, and slightly burning; some swelling
above the left eye; two red spots and a blotch under the right
corner of the mouth; the arm, on waking, was not so red and swollen
as soon after, when the itching and burning commenced; on waking;
the redness and inflamed part passed over very gradually into
healthy-looking skin towards the elbow, less so towards the other
sides, but soon after rising the burning and itching reappeared,
which was presently followed (without scratching) by increased
redness, inflammation, and an eruption of blotches, vesicles, small
pimples, and spots like measles; the eflorescences were around the
evenly-inflamed part (which was about seven inches long and six
inches wide), forming a border between that and the skin, most
numerous near the former, and especially on the side of the ulna and
around the wrist; this border itched most; the swelling was of
greater extent than the inflammation, and continued so through the
whole proving.
- (Part 5 of 11) All these symptoms, although they on the whole had
grown daily worse, were periodically better; this periodicity,
however, was the same when the disease decreased; every attack, from
six to eight a day, commenced with itching, then increased
inflammation, after which, red spots of various sizes, like measles,
appeared on the border, finally, blotches, vesicles, and little
pimples; the three later eruptions were particularly full, and the
inflammation of the whole arm vastly increased when the itching
caused me to scratch, which I sometimes could not possibly avoid;
this itching was perfectly intolerable; at such times I would put
the arm in very cold water, which gave immediate relief, and if I
kept it in about eight or ten minutes, it would gradually subdue the
inflammation and eruption and bring the arm to its usual appearance;
I could at any time cause an attack by the slightest rubbing; they
were also brought on by heat or violent bodily exercise, but
especially by close study; they were least frequent during
conversation, light bodily exercise, or when in a cool atmosphere;
for this reason I commenced bathing the arm occasionally in cold
water; these general remarks pertain to the whole proving. On severe
external pressure, pain deep in the arm, as if on the whole proving.
- (Part 6 of 11) On severe external pressure, pain deep in the arm,
as if on the bone; an eruption, like measles, over the third,
fourth, and fifth metacarpal bones, and vesicles on the fingers of
the left hand; the latter appear and disappear very quickly, causing
most violent itching; the affected part is painful, like a sore
spot; transient itching on different parts of the body; the left arm
measures one inch more in circumference than the other; in the
afternoon, vesicles on different parts of the body, with violent
itching; the swelling to the middle of the metacarpal bones; at
noon, drawing pain in the large nerves of the arm, from the armpit
downward; during the night I keep, against my habit, the arm outside
the bedcover, as the heat in the bed quickly causes itching.
- (Part 7 of 11) On awaking on the nineteenth day, a severe attack
of itching; the swelling reaches upward two inches above the elbow,
and downward almost to the fingers; almost the whole forearm is
violently inflamed, strikingly like a phlegmonous inflammation and
is, at the inflamed part (uncovered), nine degrees hotter than the
other arm; the temperature was not taken during an attack of itching
and eruptive outbreak; when there is none the skin smooth, tight,
and shining, at times painful, as if from a sore or wound, which
looks as if the skin would peel; itching on different parts of the
body; to-day very few blotches and vesicles on the arm, probably on
account of the occasional bathing in cold water, though the swelling
and inflammation are of greater extent than on any previous day;
towards evening the inflammation not circumscribed, but is very
gradually passing over into healthy skin; as the affection of the
anus does not seem to have increased during the day, it appears to
have come to its height.
- (Part 8 of 11) On the twentieth day, after 7 A. M., a severe
attack of itching; the skin of affected part peels off, and the new
skin looks healthy, but inflamed, and is very sensitive; directly on
this two pustules, with six or seven very small ones near them,
filled with matter, and the larger ones with an inflamed halo around
them; oedema on the back of the hand; itching on different parts of
the body, but on attempting to rub the spot the sensation
immediately passes to another place near by, in the evening the
swelling as large as on the seventeenth day; about two-thirds of the
skin at the place of application has peeled off.
- (Part 9 of 11) On the twenty-first day the itching is most around
the wrist and elbow and on the inside of the arm, none on the place
where the poison was applied, which has peeled entirely; the arm has
pretty nearly the normal temperature; the skin looks normal, only a
little redder, and not shining in appearance. On the twenty-second
morning another eruption of small pustules on the same place, but a
little larger than yesterday; the skin peels off again on the
affected spot, and still looks red, as well as the skin about it,
though the latter is not so red as the former; the arm still
somewhat swollen; the thickness of a fold of skin is not sufficient
to account for the comparatively large circumference of the arm,
consequently the parts under the skin must also have been affected
and swollen, and are still somewhat so; when the affection was the
worst, it was absolutely impossible to form a fold of the skin on
account of its thickness and hardness.
- (Part 10 of 11) On the twenty-fourth day the swelling is almost
wholly gone, the skin almost normal, only a little redder and
thicker at the affected part; it commences to peel off at the edges;
itching around the elbow and wrist; vesicles. On the twenty-seventh
day the skin of the whole forearm peels, and large pieces can easily
be got off; itching; a few very small scabs of serum; the skin
around the wrist thickly callous, rough, with vesicles and blotches.
On the thirty-second day the skin on the place of application,
though better, looks still red and is still thickened; this
appearance lasted several weeks, and has disappeared very gradually;
the skin on the left forearm looks normal, but is very irritable, as
the slightest rubbing causes a very profuse eruption of blotches,
vesicles, and small pimples. Forty-sixth day; there has been violent
itching several nights in succession, especially on the back, but
daytime on the face, neck, and hands, followed soon by the
appearance of red spots, blotches, vesicles, and little pimples.
- (Part 11 of 11) From this time up to five months later, nearly
every night, especially at midnight, I had severe itching,
particularly on the back; it then began to be less frequent;
generally it wakened me, as I commenced scratching while asleep, and
in this way increased the affection and itching, but if the waking
was from some other cause, I was sure to have an attack; scratching
with the hand aggravated it greatly; rubbing with a soft brush gave
relief, but it was entirely subdued by washing with cold water or
snow; at night I placed my back several times on snow for relief;
doing this in a cold room, it seems singular that I never took cold,
although I left a warm bed, very thinly clad, to go out-doors for
snow, the mercury being frequently twelve or fifteen degrees below
zero; my back presented during this time a shocking appearance; it
had been severely scratched, and was covered with bloody scabs;
during the attacks it was burning hot, and covered with blotches and
pimples, [a16].
- Some of the party suffered severely, the inflammatory action
reaching up the arms to the trunk in one, in another only as high as
the elbows, whilst in a third the effects were confined to the
hands, which, as usual in these cases, became swollen, inflamed, and
finally ulcerated, [a24].
- Itching over the whole body (sixteenth day); the next day when
rubbing the itching places, red spots appeared on the arms and
hands, [a13].
- Fine vesicular eruption on the forearm, wrist, back of the hands,
between and on the fingers, also scrotum and ankles; the vesicles
are situated upon an inflamed erysipelatous base, and accompanied
with most intolerable itching, especially in the evening, in a warm
room, and in bed; after scratching and rubbing the parts (which
cannot be resisted) the itching is intolerable; large quantities of
serum run from each vesicle after it is scratched, [a15].
- As soon as the desquamation had nearly ceased, two large furuncles
diarrhoea stopped, but as soon as the boils began to heal, it came
on again. After checking the diarrhoea a large furunculus appeared
on my right thigh anteriorly; this was very malignant, and continued
to slough for four weeks; when the "core" sloughed out, a cavity was
left into which you might easily put the end of your index finger.
Seven more boils of smaller size appeared on the same thigh, and
were all painful; when they healed, they left the surface of a
bluish-red, and soon became a bright-red. Three boils also made
their appearance on my face, though very painful, they were not very
large, [a12]. - Itching in palm of left hand, and appearance of
vesicles on fingers of left hand, itching terribly, aggravated by
cold water; in the evening, itching of hands continues; vesicles
appear on fingers of both hands (seventh day); as soon as he feels
confortable, and when falling asleep, the hands begin to itch and
prevent his sleeping for an hour (eighth day); troublesome itching
and burning of hands and fingers (ninth day); intense itching of
hands upon awaking and immersing in water, showing after rubbing
little raised streaks of a yellowish color; this is composed of
patches of little yellowish vesicles, worse between the fingers and
in the cracks or lines in the palms; itching worse in the morning
(tenth day); hands smart and burn considerably after scratching and
rubbing them (eleventh day); itching of hands and fingers same as
yesterday, showing the same yellow patches previously described; the
fingers are much swollen, also the palms (twelfth day); wakes up
during night with itching of the hands; rubs and scratches them
until sore; violent burning and smarting, preventing him from
sleeping a long time; hands itch violently through the day, relieved
by putting them in very hot water, as hot as can he borne without
scalding; this seems to make the pain felt in the very bones, but
relieves for some hours, after a thorough soaking; hands and fingers
swollen, cannot wear his ring, which generally is too large for him;
the skin appears raised in ridges of a yellow color, puffy to the
touch, the other skin on hands appearing red; hands become sore from
severe rubbing, and vesicles appear between fingers (thirteenth
day); itching on rising, same as for three or four days; cold water
allays a little for the time being, but the itching and stinging can
be felt very distinctly; yellow puffy ridges on palms of hands
(fourteenth day); wakes at 4 A. M., and has to rise and wash hands
in order to allay the itching, rubbing only making it worse; itching
of hands during the day (fifteenth day); skin peeling off fingers
and palms (twenty-fourth and twenty-ninth days); skin peels off
most, and began to peel when the vesicles were on fingers and palms
(thirty-fourth day); skin peeling off slowly (thirty-six day); skin
still peeling off (fortieth to forty-eighth day), [a20].
- Complete desquamation of the cuticle of the palms of the hands and
fingers, three different times, [a15].
- Slight vesicular eruption on the backs of the hands and about the
eyes, which disappeared in a short time, without further
inconvenience, [a4].
- Eruption of pimples and minute vesicles, with excessive itching on
the backs of the hands and between the fingers (third day); same
symptoms with increased violence (fourth day), [a10].
- Hard elevated pimples on the hands, on which vesicles appear, with
great itching, [a7].
- Hands hard, rough, and tender, [a15].
- This morning vesicles made their appearance in the palm of the
left hand wherever the sap of the plant had touched the skin in
gathering it (ninth day), [a10]. - Itching hives, deep under the
skin, in the palms, [a7].
- Large fissures on the ends of the fingers, that bleed readily,
[a15].
- The end of the fingers have a number of cracks on them, that bleed
from the - Vesicles as clear as water, clustered especially on the
fingers, [a7].
- Clusters of vesicles on the fingers and other parts of the body,
at first itching, afterwards burning and painfully sore, [a7].
- Intolerable itching and burning in the left foot; itching
increasing in intensity as the usual means were applied for its
relief. Watery vesicles (left foot), not papillary, but merely a
rising of the cuticle; in some places the vesicles were confluent
(left foot); skin became congested, thick, and stiff, attended with
a severe sensation of weight and burning; at this time the itching
became, so intolerable, that I often applied physical force to the
parts affected, hammering them with my knife-handle, or striking my
foot against the sharp corners of the bestead rail; this rendered
the itching more intense, so that I was obliged to desist from any
effort to obtain relief; exercise increased the itching; partial
oedema of the left foot; also itching and burning of the same
character (as experienced in the foot) in other parts, scrotum,
forehead, eyelids, forepart of the neck, and on the right foot,
attended with a slightly puffed appearance of all these parts; on
the fourth day of my illness, appeared vesicles on the right foot,
and formication occasionally in the swollen parts, prickings as from
excessive summer heat; vesicles with itching and burning on the bend
of the left elbow; sensation of intense fulness, itching, and
burning in the right foot; on the morning of the fifth day, vesicles
began to break, and scabs formed; oedema of the legs, pit remaining
after pressure; on the sixth day, vesicles on the fingers and back
of right hand; as the vesicles broke and desquamation commenced,
acute inflammation of the surface (feet, hands, etc.) of a darked
color, suppervened, with intense prickling heat, as though a hot
iron plate was held in close proximity to the swollen parts;
suppuration of the whole of the superior surface of the left foot,
and occasional patches of the size of a half dime (4d. English) to a
dime (6d. English); extending half way to the knee; suppuration in
patches of the right foot and fingers of the right hand; deep,
corroding, phagedenic ulcers, burning prickling, and oedema
continuing; the ulcers discharge a thin straw-colored, acrid and
very fetid pus, the odor was precisely similar to that experienced
in the dissecting-room. The intensity of symptoms continued about
three weeks, but it was three months before I was entirely free from
all the symptoms, [a11].
- Ankles very red and swollen, with watery vesicles all over the
ankles, feet, and toes, that discharge large quantities of water,
[a13].
- Large watery vesicles on the ankles, that are very painful, night
and day, [a15].
- Very large watery blisters on the sides of the feet, [a15].
- Violent itching in various parts of the body just as after
fleabites; biting, [a7].
- Itching of the skin on various parts of the body, [a19b].
- Itching suddenly, here and there, [a7].
- Itching worse after midnight and in the morning, [a7].
- In all the provings, the itching was worse on the cuticle and
mucous membrane; hot water always relieved the itching, [a20c].
- Violent itching behind and below the right ear (eleventh day),
[a13].
- Itching behind the right ear (fifteenth day), [a13].
- Itching of face, in the evening, particularly the lips (third
day); itching of upper lip (fourth day); of face and lips, and
somewhat of fingers and lower limbs (fifth day); of face,
particularly the nose, and some on lower limbs (sixth day); some
itching of lips and lower limbs (seventh day), [a22].
- Creeping sensation on face and arms (third day), [a22].
- Slight itching and burning in the face, particularly about the
eyes and forehead, and voluptuous itching on the scrotum and prepuce
(first evening), [a10].
- The itching is so intolerable that it is impossible to resist the
inclination to scratch; after scratching, the parts burn and sting,
become more swollen, and feel stiff and dry (third day); same
symptoms, with increased violence (fourth day), [a10].
- After scratching for a few minutes, the itching is entirely
relieved for several hours (third day); same symptoms, with
increased violence (fourth day), [a10].
- The itching and swelling on the face, between the fingers, and on
the scrotum and prepuce became so intolerable, that, fearing it
would incapacitate me for business, I took Rhus tox. 6th, every four
hours, and bathed the parts with cream. This treatment alleviated
the symptoms somewhat (fifth day), [a10].
- The itching and swelling in the face is very much abated, as well
as that on the scrotum and prepuce (sixth day), [a10].
- The itching comes on at intervals of five or six hours, but it may
be produced at any time by rubbing or scratching (sixth day), [a10].
- Constant itching of the under lip for several days, with a bright-
red
- The burning pain and itching of the face were beyond endurance
(third day), [a6].
- Itching of chin and upper lip (after six hours, third day), [a20].
- Nose itches severely (third day), [a20a].
- Nose itches at night (fifth day), [a20].
- Itching at anus; in the afternoon the itching becomes exceedingly
annoying, relieved temporarily by scratching; in the evening becomes
so unbearable that he cannot sleep; pinching and pressing afford no
relief; brandy applied on a compress affords relief and abates the
pain in two or three minutes, but when first applied creates such a
terrible burning that he cannot lie still, and almost goes into
spasms (seventh day); wakes up at 3 A. M., with itching of anus,
that yields to application of brandy as before (eighth day); very
little itching at anus (ninth day), [a20].
- Itching of genitals, especially prepuce (eighth day); slight
itching of genitals (ninth day); itching on scrotum and prepuce
worse (tenth day); troublesome itching of the scrotum, penis, and
especially of the prepuce, worse on becoming warm (weather
exceedingly hot), (eleventh day); itching of scrotum, penis, and
prepuce through the day, unchanged by scratching (twelfth day); very
slight itching on genitals (thirteenth day), [a20].
- Considerable itching of the penis and scrotum (first evening);
intense itching of genital organs, lying awake to scratch (first
night); itching continues unaltered; warm water ameliorates; fine
eruption around neck of penis; intolerable burning and itching of
whole genital organs; intense heat of penis, especially on the
glans, at 12 M; at 7 P.M. , the itching on genitals becomes
unbearable; relieved by warm-water cloths applied to parts; after an
hour's constant application, the itching almost entirely disappears;
the water has to be changed frequently, and can be borne up to
boiling heat; prepuce considerably swollen (twelfth day); itching
occasionally on penis and scrotum, through the night; prepuce very
much swollen, as also glans penis; desire for an embrace, but the
itching and burning are so severe that he cannot complete the act;
his wife complains of a terrible prickling and burning in the vagina
after coition, lasting several minutes (second night), [a20a].
- Itching unbearable about once in five or six hours on the prepuce
and scrotum (third day); same symptoms, with increased violence
(fourth day), [a10].
- Severe itching and burning of the scrotum, [a15].
- Awoke with burning pain and itching of the scrotum, about 2 A. M.,
[a6].
- The palms of the hands are very dry, and the inside cuticle hard
and burning hot all the time, [a13].
- Scratching is followed by excessive burning, and between the
fingers by a dull aching pain, the skin becoming more swollen, hard,
and white, as in urticaria (sixth day), [a10].
- The itching on the hands and between the fingers is very
harassing, and is much increased by rubbing and scratching (sixth
day), [a10].
- The itching returned at bedtime, and was somewhat troublesome
through the night (sixth day), [a10].
- This morning the itching returned with great severity in the
hands, and was relieved by bathing with hot water, also in the
evening (seventh day), [a10].
- Hands have been very troublesome at intervals of twelve hours
during the day (ninth day), [a10].
- Itching and burning in the palm of the left hand and between the
fingers of both hands, have been very annoying, almost painful at
intervals of ten or twelve hours (ninth to sixteenth day); itching
abating (sixteenth day), [a10].
- Violent itching in the palms without visible eruption, [a7].
- Itching of hands (fingers and palms) after washing (sixth day),
[a20].
- Itching of the thighs (third day); with increased violence (fourth
day), [a10].
- At night itching and redness on the inside of the thighs, from the
perinaeum to the knees (fifth day), [a10].
- Thighs and skin covering lower portion of abdomen itched
considerably (seventh day), [a10].
- Some itching on thighs and scrotum (eighth day), [a10].
- Most intolerable itching of the ankles, feet, and toes, aggravated
by warmth, [a13]
