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ALCOHOL AND THE HUMAN BODY In fact alcohol was known to be a poison, and considered quite dangerous. Definition.—An acute inflammatory affection characterized bythe formation of pin-head­ to small pea-sized vesicles, grouped, andoccurring about the face or genitalia. Symptoms.—The eruption is commonly foreshadowed by a feel­ing of heat and burning in the part. While the facial and progenital region are the usual seats of herpessimplex, yet instances are not rare in which the eruption (usually asingle patch) occurs on other parts.
After several days, or earlier in slight cases, they begin to dry up,and form a thin crust, which in the course of two or three days dropsoff.
Herpes Progenitalis.—Herpes about the glans and prepuce in themale, and the vulva in the female, is also not uncommon.
Herpes progenitalis is believed, in the male subject at least, to bemuch more common in those who have previously had some venerealdisease (Greenough, Diday and Doyon, Fournier, and others),2 moreespecially gonorrhea; while this is unquestionably true, doubtless thisapparent overwhelming frequency may, in part, be explained by thefact that individuals addicted to sexual indiscretions are readily alarmedby the appearance of any lesion on this part, and thus come more fre­quently under the eyes of the physician than those who have no reasonto be suspicious. Herpes is certainly neurotic It is possible that it may dependupon reflex irritation of the neighboring sympathetic ganglia, due tolocal or internal irritation.
6 Ravaut and Darre, “Les reactions nerveuses au cours des herpes genitaux,”Annales, 1904, p. Herpes of the genitalia presents similar features to that of the face;the presence of several or more small vesicles on a red or inflamed basescarcely permits of error. Ordinary herpes occurring about the lips or other parts of the facerarely requires more than external applications; in persistent and oft-recurring cases, however, the general health of the patient must be lookedafter, special attention being given to the state of the digestive tract andto possible malarial conditions. In obstinate and recurring genital cases daily applications of the gal­vanic current will prove of value; the positive electrode is placed overthe lower lumbar region, and the negative over the affected part, thecurrent being mild—? to 2 milliamperes. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! It generally consists of but oneor two groups, which may be small or large; or several or more clustersmay present.
They show no tendency to spontaneousrupture, but should they be broken open, a superficial abrasion or excori­ation results, crusts over, the crust subsequently falling off. 81.—Herpes simplex of somewhat extensive development in a girl of ten years,of four days’ duration. In occasional instances there is notonly a tendency to recurrence, but to recurrence on the same spot;1the lips, chin, cheek, and buttock are favorite localities for this recurrenttype.


Sometimes one or two of the vesicles are broken and the patchis then excoriated at these points, serum oozes out, which dries to athin yellowish crust. It mayconsist variously of one or several groups, but it is rarely seen in suchabundance as frequently observed on the face. An irritable or decayed tooth seems in some instancesof recurrent cases the exciting factor. A long prepuce predisposes to it, and coitus is alsooften the exciting factor; in some instances an attack follows each in­dulgence.
In fact, the disease is considered by someto be an abortive or irregular zoster, a view scarcely to be accepted.Kopytowski5 found considerable histologic analogy between herpesprogenitalis and zoster.
A microbic origin has also been sus­pected in herpes, but, while possible, it does not seem probable.
When abraded and irritated by the moistureor secretions of the part, or cauterized by some overzealous physician,there is sometimes great difficulty to distinguish it from a soft sore andpossibly from hard chancre. When the crusting stage is reached, ointments, such ascold cream, camphor ice, etc., can be used, the crusts usually separatingmore quickly under such applications. A mustard plaster over thelower spine, daily or every few days, is sometimes useful in this classof cases.
The vesicles, which are usually seated upon a hyper-emic or mildly inflammatory base, are pin-head or slightly larger in size,often crowded close together so that sometimes it may be somewhatdifficult to make out their individuality; this is especially so on the lips,but on other parts of the face the lesions, while grouped, are quite clearlydiscrete. As a rule,however, they remain unbroken throughout, and gradually dry to thincrusts of a yellowish or brownish color, which finally drop off and leaveno trace. I have seen several children in whom a patch had so presented onthe cheek once or twice yearly for several years or more.
11, 1907, records several such instances and refers to several otherpapers of his own and others recording cases in which the recurrence was in the sameplace; Adamson, Brit.
When on other parts than the lips or mucousmembrane, the eruption is occasionally quite abundant. In some instances, especially on other partsthan the lips, the lesions may coalesce and form a small bleb; as a rule,however, this does not take place. Slight burning and itch­ing are usually first noted, rapidly followed by the appearance of a slightlyred, and sometimes a little puffy inflamed area, upon which are soon seenseveral or more minute vesicular points, which slowly increase to the sizeof a pin-head, sometimes larger.
Bergh3 found that in women an outbreak is concomitantwith, precedes, or follows menstruation, and that in women it is not a“professional” (prostitute) disease, although Unna's4 experience does notagree with this.


It can scarcely be confused with vesicular eczema, as thislatter disease is made up of closely crowded small vesicles, which tendto coalesce, but with no tendency to form distinct groups; is slow,as a rule, in its appearance, usually presents some inflammatory thick­ening, the vesicles are smaller and rupture spontaneously and giverise to gummy exudation.
The absence of glandular enlargement inherpes or, at the most, of slight transitory swelling is a differential pointof value. The same may be said of the administration of arsenic, bothin herpes facialis and herpes progenitalis.
In some cases in which the lesions may be few and the conse­quent group small and insignificant, the contents may be reabsorbed, andthe disease be shortened or aborted. Unless irritated, the crust formeddrops off in from several to ten days after the disease has first presented.When near or at an angle of the mouth, from the act of opening andshutting the mouth, slight fissuring is sometimes noticed, and the con­stant irritation of the food and saliva may keep the part macerated andsore for one or two weeks or longer. They dry up, or the contents are ab­sorbed; slight crusting ensues, and the disease, under favorable circum­stances, in the course of several days or so disappears. As to relative frequency in the two sexes, it is thegeneral opinion that it is much more common in the male, althoughUnna‘s and Bergh‘s statistics do not bear this out, the last named, infact, believing it more common in women. Chancroids are usually multiple, with distinct ulceration.In doubtful cases, when a hurried opinion is necessary, auto-inoculationexperiments can be made.
The malady is also seen in the mouth,and shows two, several, or more vesicular lesions crowded close together.At first small, the lesions often increase in the course of some hours orone or two days to the size of a small French pea. Or the lesions maybe rubbed or chafed, rupturing taking place, giving rise to one confluentexcoriated surface or several excoriated points; and then the duration isusually much longer, inasmuch as the surface is continually irritated bythe secretions and probably occasionally by the urine, and resulting in aslight abrasion or even superficial ulceration, which may give rise to con­fusion with a soft chancre. This paper, and the several preceding, all on genital herpes, are full andexhaustive and give many literature references. Ordinarily the beginning induration of asyphilitic chancre will serve to differentiate, together with the history ofits appearance. A form of “herpetic fever” hasbeen recorded from time to time, occurring epidemically (Savage, Sea-ton),1 usually preceded by a rigor or distinct chill and other symptomsof general disturbance; the outbreak is generally limited to the lips andregion of the mouth, in some cases involving also the ears.
In some instances it must be acknowledged it is notpossible to give a definite opinion at once, but the application of theappropriate treatment for herpes will soon heal this disease, whereas muchtime is necessary for both chancroid or chancre to bring about such result;for the latter an examination for spiroch?t? would settle the matter. 354 (always favorable); Schamberg, “TheNature of Herpes Simplex and the Diagnostic and Prognostic Significance in VariousInfectious Diseases,” Jour.



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Comments
  1. Samirka 05.11.2013 at 12:10:35
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