May 1941]

CASE REPORTS: DERMATITIS VENENATA

507

EtAse 3Reports
A CASE OF RUBEOLA DURING THE

PUERPERIUM BY Mv. LERNER Cut Knife, Sask. I am reporting this case of measles during the puerperium because of its rarity and the successful treatment of this serious association.
Mrs. W.R., aged 20, para-i, grav-ii, was admitted to the Cut Knife Municipal Hospital on October 20, 1940, at about 4.30 p.m. She was having labour pains at 5 minute intervals, and complained of having a "cold", and a dry hacking cough. There being a measles epidemic in the district, she was questioned, and admitted that she was a contact and that she had not had the disease previously. The labour was normal and she was delivered of a male child weighing 8 pounds. The patient and baby were isolated. The following morning, October 21st, on examination, Koplik spots were seen on the buccal mucous membrane. The patient was given 20 c.c. of her husband's blood intramuscularly, the latter having had measles some ten years before. The baby also received 20 c.c. of blood from the same donor into the gluteal region. The baby was taken off the breast and separately isolated. That day the patient's cough became worse and her temperature rose to 1020 at 4 p.m. On October 22nd a rash appeared, typical in type and distribution. The patient was miserable, and the temperature climbed to 103.0 She was given, in addition to the usual prescribed treatment, prontylin, gr. 10, NaHCO, gr. 10, and methylene blue, gr. 1, O.H.8. On October 23rd the raslh had appeared all over her body, and while abundant on the upper half the spots were scarce on her lower limbs. Her eyes were extremely painful, but her temperature had dropped to normal. The following day her temperature rose to but 99.4, dropped to normal on the next, and remained there until the day of her discharge, October 31, 1940. The rash began to fade on October 24th and was completely gone by the 26th. The baby showed no signs of illness or rash and 3 weeks after birth there is no evidence of measles.

information given in any books the writer has been able to consult.
R.H., female, aged 20. Complaint.-Blistering on the right buttock said to have been caused by poison ivy. She had been getting a typical allergic reaction to something in various parts of the body for the last two weeks since contact occurred. Now she had a rash on one thigh which gave a burning sensation. The patient was given 10 e.e. of 10 per cent calcium glucono-galacto-gluconate* intravenously. The rash on the thigh faded in a few minutes and the discomfort was relieved. She was given prescriptions for ephedrine hydrochloride (gr. %) and calcium gluconate, to take orally if symptoms returned. She reported later that the condition did not return. G.H., a male, aged about 21. This young man was working around poison ivy four days before and got a severe dermatitis on face, arms, hands, legs, etc. He continued to react severely and the rash "burned " very much at times. He was given 10 c.c. of 10 per cent calcium glucono-galacto-gluconate intravenously. The patient fainted briefly from psychosis as he had never "had the needle" before. He recovered promptly from the faint and said he was relieved of the burning sensation. The rash paled somewhat. He was given prescriptions for calcium gluconate, ephedrine hydrochloride tablets, and a soothing ointment. He promised to return if not definitely better, but he did not return. R.W., a male, aged about 58. Complaint.-Pain and swelling of both eyelids and tissues, and blebs over the left side of the forehead. History.-The fact that this man had psoriasis on his arms and abdomen for the last ten years does not seem to have any bearing on the present case. Eight days ago his forehead broke out in a pimply rash. The area was very tender. It started at the outer margin of the left eye and extended up over his forehead. Three days later his left eye was closed and the swelling had spread to the right eye and down the left side of the face. The affected area was very sore and throbbing. Eight days after the initial lesion, the appearance was that of an allergic reaction rather than herpes, and was still smarting and stinging, but he said he felt somewhat better. The patient attributed his trouble to flies (which were thick) or to some plants with which he came in contact while working around with weeds. He was admitted to hospital. His temperature was 1010 on the evening of the day of admission, but otherwise remained within normal limits. He was given calcium intravenously on three consecutive days as well as calcium lactate (gr. 10 t.i.d.). The condition rapidly improved, the swelling subsided, and the rash dried and disappeared in three or four days. G.A., a druggist, came to the office with an acute dermatitis on both hands and forehead. His arms and hands were noticeably swollen, and he said that they felt tight when his fingers were flexed. He attributed the condition to exposure to poison ivy four days before. He had been treating the area himself by frequent applications of Dakin's solution and tincture of iron. He was given 10 c.c. of calcium glucono-galacto-gluconate intravenously. Within a few minutes he reported that his hands felt less swollen. He was advised to take calcium gluconate by mouth, and he was to take % gr. of ephedrine if any severe symptoms developed. The condition continued to improve rapidly, the red rash fading and the swelling being reduced. Within two or three days the patient considered himself cured.
* Calcium glucono-galacto-gluconate "Calcium Sandoz " is the new formula prepared by Sandoz Laboratories.

I believe that the blood injection, though given late, modified the course of the disease in the case of the mother and prevented it in the baby. The prontylin no doubt prevented secondary infection from setting in.

TREATMENT FOR DERMATITIS VENENATA

BY K. A. BAIRD

West Saint John, N.B. Even four swallows "do not make a summer", nor do four cases prove the value of a treatment, but the following case histories seem to suggest a useful line of treatment for poison ivy dermatitis, especially in view of the paucity of the