ERYTHEMATOUS RASH LOCALIZED 



1515 



2. (Edema of face and eyelids and gastro-intestinal dis- 



turbance, eosinophilia, and leucocyiosis — Trichinosis, 



3. No oedema of the face and eyelids. Very rare — Polymyo- 



sitis. 



4. Swollen area affected with leprotic eruption. Signs of 



leprosy in various parts of the body — Leprotic fever. 



(b) Not associated with oedema : — 



^'r. Severe constitutional symptoms and marked backache; 

 signs of vaccination absent, poor, or old. Case of 

 smallpox known to exist in neighbourhood — Suspect 

 smallpox. 



2. There is a recent wound due to a rat -bite, or a history 



of a rat -bite seven to twenty-one days previously, 

 of which the wound may have healed. Site of bite 

 red and swollen, becomes ulcerated. Enlarged 

 lymphatic glands. Erythematous eruption with 

 purple spots— Rat-bite fever. 



3. History of a cat-bite some ten to twenty-one days 



before illness; maculae around site of bite and then 

 on limbs; infiltration of skin, enlarged lymphatic 

 glands. Pains in muscles and joints. Splenic en- 

 largement. Fever relapsing in type — Cat-bite fever. 



4. Pains and aches all over the body, but constitutional 



symptoms not very severe. Rash appears with the 

 fall of the temperature on the third day. No malarial 

 parasites in the blood. Stegomyia (or Culex) mos- 

 quitoes abundant. Endemic ity of dengue-like fevers 

 known — Dengue. 



2. PAPULAR ERUPTIONS. 



These eruptions often form part of the evanescent early symptoms 

 ot some fever, and are therefore difficult to arrange in a satisfactory 

 manner. The practitioner will remember that drugs like iodides 

 and the bromides ma^^ give rise to papular eruptions. 



L Catarrhal symptoms present : — 



Maculo-papular eruption tending to form blotches. Koplik's 

 spots present— M^as/^s. 



IL Catarrhal symptoms slight or absent 

 {a) Constitutional symptoms severe : — 



1. Markedly severe headache and backache. Papules 



bright red and shotty, appearing between the third 

 and fourth day, first on the forehea.d — Smallpox. 



2. In a child which has been ill for three days with pain all 



over the body and often delirium or convulsions. 

 Papules about the size of a pin's head on chest, back, 

 and abdomen — Dengue (Van der Scheer's fever). 



