Herpes Labialis after Sulphapyridine and T.A.B. Therapy
Authors: C. E. van Rooyen, A. J. Rhodes, A. C. Ewing
Journal: BMJ (1941)

Although  labialis is clinically a harmless infection its causal agent has been the subject of much research. The condition is often seen in soldiers, and a Swiss regimental physician (Mayer, 1921) has described a spontaneous out break of 30 cases among 70 soldiers who slept in one barrack-room. Five of the 6 officers attached to the same unit were also involved. Last winter we observed 33 cases among hospital patients and investigated them from the laboratory point of view. Two classes of persons suffering from herpetic eruptions were studied-namely, normal healthy nursing orderlies, who developed it spontaneously, and a larger group comprising patients treated for gonorrhoea. Before beginning our description of the clinical-patho logical findings and animal inoculation results we should like to present a summary of modern conceptions regarding the aetiology and pathogenesis of herpes. The disease was first proved to be infective by Vidal (1873), and thereafter the classical researches of Levaditi, Doerr, and others showed that the causal agent was a filterable virus which was highly pathogenic to the rabbit, and which produced violent keratitis if implanted upon the scarified cornea of that animal, occasionally followed by meningitis and death. Individual strains of virus differed in their neurotropic affinities for the rabbit; consequently attention turned to  simplex virus as being a possible cause of encepha litis lethargica, and Levaditi and Harvier (1920) claimed to have isolated the virus from such cases. Unfortunately, independent confirmation of Levaditi's researches was lack ing and the work fell into disfavour, but it may still prove that his investigations were made in advance of the times. The clinical nomenclature employed for the designation of the various manifestations of herpetic infection in man is unsatisfactory. Thus the usage of terms such as herpes simplex,  febrilis,  labialis,  recurrent herpes, and  idiopathic and symptomatic   indicates that the classification is inconsistent, and not based on anatomical, clinical, or aetiological grounds. For the convenience of readers over-seas the following account contains a sum mary of the facts respecting the clinical types of  and their aetiology. At the outset it should be understood that all forms of  affecting man, other than  zoster, are due to one and the same virus, which is pathogenic to the rabbit, whereas the virus of  zoster is a separate entity which is non-pathogenic to the rabbit and probably related to the virus of varicella. Both  and zoster viruses are particulate and visible organisms which occur in the form of minute virus elementary bodies, and Elford et al. (1933) have succeeded in measuring  simplex virus, estimating it to be 100 to 150 mu in diameter. Herpes virus also produces specific histological changes, and acidophilic intranuclear inclusion bodies have been described in human corneal epithelium (Fuchs, 1933) and in the large epithelial cells present in human vesicle fluid (Da Fano, 1923). Clinical Varieties of Herpes Herpetic infection may appear in a variety of forms, as follows: