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The desiccation and the desquamation occupy an exceedingly variable length of time; and so, indeed, do all the different periods of the disease. What is the least inconstant, is the duration of the serous eruption, which is about four days, if it has been distinctly produced and guarded from all friction.
Desquamation of the epidermis is the invariable feature of all cases, and it usually commences between the fourth and eighth days. In severe cases successive layers of the epidermis are shed, in larger or smaller scales, throughout the whole course of the malady. One-half of the epidermis shed from the hand of a patient is exhibited in this collection.
A dry scab forms at the furrow, and when picked and repicked constantly re-forms, being composed of horny desquamation or necrosis.
The symptoms were preceded by restlessness, headache, and heat of the skin, and subsided gradually after the second or third day, desquamation continuing for nearly two months. After they had subsided entirely, the exhibition of arsenic again aroused them, and this time they were accompanied by salivation.
After becoming papular and increasing to the size of a pea, desquamation takes place, leaving a dull-red surface, over which in the course of several weeks there develops a series of small yellowish-white spots, from which serum exudes, and, drying, forms a thick scab.
Lang observed a case in which the fingers alone were affected. There is a case of general and habitual desquamation of the skin in the Ephemerides of 1686; and Newell records a case which recovered under the use of Cheltenham water for several seasons.
The untoward effects of opium and its derivatives are quite numerous Gaubius treated an old woman in whom, after three days, a single grain of opium produced a general desquamation of the epidermis; this peculiarity was not accidental, as it was verified on several other occasions. Hargens speaks of a woman in whom the slightest bit of opium in any form produced considerable salivation.
At another time 1 1/2 grains of the drug gave rise to herpetic vesicles on the cheeks, followed by branny desquamation on elimination of the drug. In other patients intense itching is experienced after the ingestion of quinin.
The south wind acting on his still weakened health? All these together? Or had he reached an epoch in his development, the termination of one of those definite life periods when all men worthy of the name pass through some cleansing process of spiritual desquamation, and slip their outworn weeds of thought and feeling? Whatever it was he seemed to be no longer his own master, as in former days.
Pastorello speaks of a child which lived for two and a half hours whose hands and feet were entirely destitute of epidermis; the true skin of those parts looked like that of a dead and already putrefying child. Hanks cites the history of a case of antepartum desquamation of the skin in a living fetus.
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