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CASE XVIII. John Baker, a child of five years old, was inoculated March 16, 1798, with matter taken from a pustule on the hand of Thomas Virgoe, one of the servants who had been infected from the mare's heels. He became ill on the sixth day with symptoms similar to those excited by cow pox matter. On the eighth day he was free from indisposition.
When the malignant pustule is fully developed, the central slough with the surrounding vesicles and the widespread œdema are characteristic. The bacillus can be obtained from the peripheral portion of the slough, from the blisters, and from the adjacent lymph vessels and glands. The occupation of the patient may suggest the possibility of anthrax infection.
Two generations back they still stood dark and empty; people avoided them as they passed by; the boldest schoolboy only shouted through the keyhole and made off; for within, it was supposed, the plague lay ambushed like a basilisk, ready to flow forth and spread blain and pustule through the city. What a terrible next-door neighbour for superstitious citizens!
It involves some risk, and is no substitute for efficient treatment by the more familiar methods. If necessary, a patient can have the benefit of both. The luetin test was devised by Noguchi for the presence of syphilis, and is performed by injecting into the skin an emulsion of dead germs. A pustule forms if the test is positive.
Similar abscesses are met with on the scalp in association with eczema, impetigo, and pediculosis. #Veldt Sore.# This sore usually originates in an abrasion of the epidermis, such as a sun blister, the bite of an insect, or a scratch. A pustule forms and bursts, and a brownish-yellow scab forms over it. When this is removed, an ulcer is left which has little tendency to heal.
The pustule was so expressive of the true character of the cow-pox, as it commonly appears upon the hand, that I have given a representation of it in the annexed plate. The two small pustules on the wrists arose also from the application of the virus to some minute abrasions of the cuticle, but the livid tint, if they ever had any, was not conspicuous at the time I saw the patient.
Wagner, who has related several cases of malignant pustule produced in man and beasts, both by contact and by eating the flesh of diseased animals, which happened in the village of Striessa in Saxony, in 1834, gives two very remarkable cases which occurred eight days after any beast had been affected with the disease.
One of the first objects then of this pursuit, as I have observed, should be, to learn how to distinguish with accuracy between that peculiar pustule which is the true cow pock, and that which is spurious. Until experience has determined this, we view our object through a mist.
The pustule on the forefinger shews the disease in an earlier stage. It did not actually appear on the hand of this young woman, but was taken from that of another, and is annexed for the purpose of representing the malady after it has newly appeared.
This they did by inoculating in the body of a child a pustule taken from the most regular and at the same time the most favourable sort of small-pox that could be procured. The experiment could not possibly fail.
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