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July 1949


Author Affiliations

Emeritus Regius Professor of Medicine, University of Oxford OXFORD, ENGLAND

Arch Intern Med (Chic). 1949;84(1):159-169. doi:10.1001/archinte.1949.00230010169026

BETWEEN 1895 and 1914, Osler published a series of four papers1 on the visceral manifestations of the erythema group of cutaneous diseases, pointing out, among other things, the frequency and severity of involvement of the kidneys in these conditions. In the three earlier papers,1a-c written between 1895 and 1904, 29 examples of visceral manifestations in patients in "the erythema group" were reported. Fourteen of these had acute nephritis, and 5 of the 14 died of uremia. Of the 14 patients with nephritis, 13 had purpura.

As Osler well knew, this collection of cases contained examples of a number of different conditions, "certain of the purpuras, angio-neurotic oedema, peliosis rheumatica, exudative erythema." A study of Osler's case reports leads me to believe that of the 14 cases of nephritis, 1 (case 14) was quite possibly an example of periarteritis nodosa, whereas the disease in 2 (cases 19 and 26)