The Fever at Croydon: And Intermittent Water-Supply as a Cause of Typhoid
Authors: A. Carpenter
Journal: BMJ (1875)

May I869.He was pale, and seemed out of health.He presented a copious eruption of vesicles and papules in various stages, and affect- ing the face, trunk, and limbs, and, to a slight extent, the scalp.The fresh spots consisted of elevated pointed papules, feeling very firm, and each surmounted by a small vesicle.In the older ones the vesicle had sometimes broken, but in the greater number it had dried up ; on the scalp, the spots had sometimes run on to porrigo.There were a few on the palms and soles.The eruption avoided the flexures; was more abundant on the back than oni the chest and abdomen.It was -vidently excessively pruriginous, and there vere numerous scratches.The mother's history was, that the rash had appeared when the child was three months old, and soon after vaccination, and that the medical man in attendance told her that it was "glass-pock".The eruption had varied in intensity at different times, but had never been quite well since its first appearance.He remained under care only two months, anid I cannot tell you the final result.CASE III.-Sarah Richardson, aged Ii months, was brought on June 22nd, I869, with a papular and vesicular rash on the trunk, linmbs, and scalp; it affected the palms and soles.The spots were at first small papules, apparently devoid of fluid; presently these became iniflamed and red at the base, while at the top was formed a yellowish point, in the centre of which a little dot was seen; while still later, a considerable red areola was present, and a concave scab was formed on the top of the spots.The mother stated that the eruption had been pr-esent for five months, and that it came soon after the child had been vaccinated.When it first came out, she thought it was chicken-pox, oon account of the " clear watery heads" which were present at thattime.An only sister of the infant was free from any eruption.CASE iv.-Sarah Ann Tosland, aged I9 months, was admitted on JulIY 13tll, I869.She was suffering from a pruriginous rash on the body and on the backs of the hands and soles of the feet; some of the spots were very like wheals of urticaria.The history given was of a gradual onset of the eruption at the age of five months, the mother thinking that it was like chicken-pox.It was said to have been well in winter.The child was of fair complexion and very stout, and seemed muscular and strong, notwithstanding the constant itching she suffered from the rash.She was the youngest of eight children, and the only one who had suffered fro.n any skin-disease.This case is not very well characterised.CASE v.-Isabella Brown, aged 12 months, a fair-skinned light- h-iaired child, was brought on account of an eruption in September 1869.The rash was general and pretty thickly distributed; it affected the soles, the face, and the scalp, but not the palms.The flexures were avoided.It was distinctly vesicular, and in parts impetiginous from scratching, but there were no large pustules.It had already lasted seven months, and was said to have come out soon after vaccin- ation.The child was nearly well in six weeks.CASE vI.-Walter F. Seymour, aged 12 months, in good health, was brought on September 24th, ;869.HIe had a copious itching eruption of papules and vesicles, with some pustules.The parts affected were the trunk, palms of the hands, dorsal surface of the feet, scalp, and, to a less extent, the face.The bulk of the rash was papular.There were, however, some large irregular vesications, with areoloe of congestion, and containing turbid fluid; other spots looked as if they had been about to suppurate, but hail dried up before pus was formed in sufficient quantity to break the cuticle; some, especially on the hands and feet, were distinctly vesicular.The rash had been taken in the first instance for chicken-pox.Under treatment, the rash im- proved for a few weeks, but very soon relapsed and became as bad as ever again.CASE VII.-Walter Thompson, aged I9 months, admitted on April 2nd, I869, on account of a very copious pruriginous eruption.He was stout and healthy-looking, and was said to have an excellent ap- petite.He had been nursed till iI months old.The eruption had appeared for the first time at the age of 15 months, and it came out about three weeks after vaccination; the vaccination spots having done well. 1-fis nurse thought it was chicken-pox; but, from her statement, it seemed probable that the spots were not so distinctly vesicular as in that disease.The eruption had steadily become worse until he was brought