P IGMENTATION—BODY SYSTEMS 



1519 



II. No history of recent vaccination: — 



{a) Localized red swelling, with several points of suppuration. 

 Examine bacteriologically for cocci — Carbuncle. 

 Localized red solid swelling, with black centre, and round 

 it pustules often mixed with vesicles and bullae. Ex- 

 amine bacteriologically for Bacillus anthracis — Malignant 

 pustule. 



(h) Generalized pustular eruption in a patient who has been 

 seriously ill for six days or more, with at times swelling 

 of eyelids, lips, or eyes — Smallpox. 



8. PIGMENTATION. 



In acute fevers the important cutaneous pigmentation is the 

 yellow tinge due to jaundice. This is rare in malaria and in the 

 early stages of the enteric fevers, and hence need only be mentioned. 

 For blood pigments in the skin see the purpuric eruptions, and for 

 black pigmentation see the chronic fevers. 



1. Liver and spleen one or both enlarged : — 



[a) Abdominal tenderness. Typical spirochcetes in blood — 



Relapsing fevers, 

 {h) Abdominal tenderness not marked : — 



1. Peculiar spirochaetes in blood and urine — Weil's disease. 



2. No spirochaetes in the blood: — 



(a) Haemoglobinuria — Blackivater fever and its allies. 



(b) No haemoglobinuria, severe symptoms, albumin- 



uria, black vomit, etc. — Yellow fever. 



II. Liver and spleen not enlarged : — 



{a) Symptoms mild. Fever slight or absent. No signs or 

 symptoms of pneumonia — Lcterus castrensis levis [camp 

 jaundice) . 



{b) Physical signs and symptoms of pneumonia. Pneumo- 

 coccus in sputum — Pneumonia. 



C. BODY SYSTEMS. 



Fevers associated with some marked sign or symptom directing 

 attention to a given system of the body may be arranged according 

 to the system deranged as follows: — 



' A. Derangements of the Alimentary Canal. 



B. Derangements of the Respiratory System. 



C. Derangements of the Circulatory System. 



D. Derangements of the Urinary System. 



E. Derangements of the Generative System. 



F. Derangements of the Lymphatic System. 



G. Derangements of the Muscular System. 



H. Derangements of the Osseous System. 



I. Derangements of the Connective Tissue. 

 J. Derangements of the Nervous System. 



