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Full text of "Diseases of the skin: their constitutional nature and cure"

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YALE

MEDICALLJflRARY

Gift of

Danbury Hospital
Medical Library

Digitized by the Internet Archive
in 2012 with funding from
Open Knowledge Commons and Yale University, Cushing/Whitney Medical
Library

http://www.archive.org/details/diseasesofskinthOOburn

Diseases of the Skin.Their Coitstitutional Nature
and Cure.

BY
J. COMPTON BURNETT, M.D.,
AUTHOR OF " RINGWORM '. ITS CONSTITUTIONAL NATURE AND CURE."

Si nonjuvat, nwdo ne noceat.
'By their fruits ye shall knotv them.

Second Edition, Revised and Enlarged.

LONDON :
THE HOMCEOPATHIC PUBLISHING COMPANY,
12 Warwick Lane, EC

1893-

PRINTED BY OLIVER AND BOYD, EDINBURGH.

NOV 1964

PREFACE TO SECOND EDITION.

HHHIS present edition I have very considerably enlarged by adding Part
Second, consisting more particularly of Cases
illustrating the Constitutional Cure of Diseases of the Skin, and this has necessitated
an alteration in the title of the work. Almost
every day brings me evidence confirmatory
of my views of the constitutional nature of
skin diseases, and I am increasingly impressed
with the dire results that accrue to those
sufferers therefrom whose cutaneous manifestations have been got rid of by lotions and
ointments.
J. COMPTON BURNETT.
86 Wimpole Street, London, W.,
Midsummer 1893.

PREFACE TO FIRST EDITION.

TN the following pages I take largely the
clinical standpoint, and consider the
Diseases of the Skin constitutionally. The
treatment of skin diseases as merely local
affairs concerning the skin only, as is now
current with nearly all medical men of all
schools and all the world over, is, in my
opinion, nothing less than a crime against
humanity, and eminently characteristic of the
cultured shallowness of the medical profession
of to-day.
In " these days of 'scopes and 'meters,"
thinki?ig, in the profession, is well-nigh
dead. One sees no end of percussing and
auscultating : the faintest murmurs, sounds,

tinkles. a healthy skin on an unhealthy body is inconceivable. possible ? and how are the bacilli to thrive unless the soil be. 2. 5. That being biologically within the organism. or constitutional.. I do maintain the following points : — i. and bruits are well known and learnedly discoursed of. its unhealthinesses — its diseases — come from within. and having its diseases from within. speaking generally. Yes. sometimes even when they initially impinge upon it from without. . it must also be treated medicinally from within. having its health from within. though illunderstood. That the skin is a very important living organ of the body. 3. 7. rales. That. but at the same time organismic. for them. having its life from within. of the right kind? I do not maintain that there is no such a thing as a skin disease of a purely local nature. That skin diseases are most commonly not merely organic. speaking generally. being fed from within. but what went on before bacillary life became vi Preface. Preface.e. vii 6. but. That its healthiness is conditioned by the general healthiness of the organism. such as common phtheiriasis and other parasitic dirt-diseases that impinge upon the skin. — i. That it stands in intimate. That the skin being an excretory organ. and being spread out all over the organism. but what of the curing ? what of the real aetiology of the Consumptive process itself? Bacilli. 4. relationship to all the internal organs and parts.

state at all. London." J. The skin does not live an independent life of itself — hung on. as it were. but only preventing its peripheral expression. and I might call upon the dermatologists to refute them. they guide me in my practice. so the skin disease is often merely the outward expression of internal disease." So it is. Sir. did I not hold them to be absolutely irrefutable. " The roots have got down on the clay. is demonstrably shallow in conception. 9. is really not treating the diseased viii Preface. wrong in theory. or other outward applications. whether with lotions or ointments or whatsoever else. "The roots have got down on the clay. so to speak. 8. If disease of the body bubbles up.is often made use of by Nature to keep the internal organs free from disease. That. and therefore inadvisable. to treat this Disease in (of) the skin by washes and ointments. he replied. rough. outside of us — but is of all our organs the most systemic . when a person's skin becomes diseased. the generally received external treatment of Diseases of the Skin. in fine. . These points embody my views on Diseases of the Skin . and when I one day asked my gardener why the bark of a certain apple tree was so knobby. COMPTON BURNETT. That as each portion of the skin corresponds vitally with some internal organ or part. into the skin like water from a spring. but what can we expect from an age in which people think they get a beautiful healthy skin from soap. and sound teeth from tooth-powder ? The bark of a tree is a very fair analogue of the skin. harmful in practice. September 1886. and unhealthy-looking. I opine.

and I could not quite see why a comparatively young lady should get such anginal attacks.history from her earliest the Skin. to the spot. QNE Sunday morning. a gentleman ushered his wife into my consulting-room because she had been taken with an attack of angina pectoris in the street. nailing her. or even functional derangement. I prescribed for her. she had been subject to these attacks of Diseases of breast . as it were. . She had been under able men for her angina. to try and elucidate the matter.pang for several years : they would take her suddenly in the street.Diseases of the Skin. some ten years ago. and hence she no longer went out of doors alone. I let her tell me her whole health . lest she should faint away or fall down dead. as was apprehended. and no one could apparently understand it. if so much. Though only a little over thirty years of age. on her way to church. An examination of the heart revealed no organic lesion. and saw her subsequently at her home. but it got no better. PART I Angina Pectoris from Suppressed Skin Disease.

for otherwise. As I have already said. and that her angina was in reality its internal expression or metastasis. dyspnoea. She said she was getting to the end of her teens. only driven in by Wilson's ointment. and palpitation. she had borne one dead child. I gave my opinion that her skin disease had never been really cured. Efasmus Wilson was consulted . these cracks in her skin had troubled her from her earliest childhood. and was preparing to come out. and very soon — I think it was less than a month from the Sunday morning visit — the old . I began to treat her anti- the Skin. and got married in due course. flatulence. and finally the beforedescribed attacks of angina pectoris threatened to wreck her life. made a hit right off. but she had some cracks in the bends of her arms that were very unsightly . and from the lady's healthhistory I gathered that this cure of her skin (though to me the one important point) was of no causal importance. psorically. he gave her an ointment which very soon cured her skin.childhood. there was no discoverable cardiac lesion. " How could I have appeared in short sleeves ? " But there soon followed dyspep- Diseases of sia. She had always felt very grateful to Erasmus Wilson for curing her arms. however. Moreover. No one believed it. and the patient came out socially.

In listening to his lifehistory. and thenceforth she bore living children. and also. and partly from loss of sleep and Diseases of much physicking. from his shortness of breath. He was forthwith free of his asthma. Not long after the beforementioned experience I was consulted by a Liverpool gentleman for asthma of a very severe type. He was somewhere near forty. Specific Enexanthematic Asthma. and he got a strange coppery condition of the skin. His skin became quite healthy. I noticed that he dated his asthma to a cold caught during a child's disease with a cutaneous eruption. judging from his subjective symptoms. lost sight of him.cracks reappeared in the bends of the elbows. About a third of his life was spent in these attacks of asthma. I treated him nearly a year on this hypothesis. at the end of which period I the Skin. and had the appearance of a very old man. much of his hair falling out at the same time. and his hair grew again. and Enlarged . Psoriasis. which peeled off almost all over his body. I concluded that he was suffering from an enexanthema. and never had it again during the two following years. and from that time on she had no further attacks of angina at all. Asthma. partly from the habitual bent position. an internal skin disease of a specific nature.

though sun and wind still affect his skin unduly. Latent Vaccinosis. enlargement of the liver. The child's head was of the usual hydrocephalic type . It is now nearly two years since he had any attack of asthma. psoriasis. he was almost sure to get an attack of asthma. his breathing was well . who had been given up by three medical men. of which a little brother the Skin. Hydrocephalus. and conversely. he was alternately wakeful and delirious at night. suffering from asthma. Their local doctors had taken a consultant's opinion. for nearly three years. In the early part of the year 1885 I was requested to see the only surviving child of a country clergyman. particularly in certain places. Eczema. After . I treated his liver and his skin for many months — in fact. The child's life-history was told to me. and eczema. as it had water on the brain. 9 had previously died. When his skin was very bad. and I underlined the facts that he had had eczema. and he talked nonsense by day at intervals. and he is well of both skin Diseases of and liver. if his skin got well. and had been twice ^successfully vaccinated.Liver. A gentleman of thirty came under my care some years since. and they agreed that the boy was suffering from tuberculosis of the meninges with effusion.

however. Seeing the grandchild's eczema. and at the end of about six months' treatment I was able to discharge the little patient. cured of his water on the brain and of his skin diseases. and he went to stay at the daughter's house. The lady's father. or eczema capitis. I prescribed for the child constitutionally. a severe pustular eruption. I saw him the other day. and learned that he continues well and has grown a good deal. io Diseases of Eczema Capitis suppressed — Fatal Issue. and prescribed unguentum zinci. About nine years ago the wife of a staff-officer brought her bonny little baby to me : it had the milkcrusty scalp. About a fortnight later I was suddenly summoned by telegram to see the child : it had been taken with convulsions from . and very soon the present disease began. She told her father the Skin. but the old gentleman over-ruled it.the ^/zsuccessful vaccinations (want of organismic reactionary power) the eczema almost disappeared. but the child seemed perfectly well and jolly. he told the mother to use an ointment to the scalp. The scalp appeared one solid crust of scabs. 1 1 of my warning not to put anything on the bad head. which soon healed the eczema. and forbade all local treatment. was a retired physician of repute. it had crusta lactea. I treated the case thus causally ex-hypothesi . and then patches of lepra and eczema appeared. so horrible to aesthetic mothers — in fact.

and there met a doctor. In August 1879 she got eczema behind the right ear. And soon after he was cured of his eruption we noticed his sight was failing — before that his sight was all right. I did my best to get the eczema back on to the surface of the scalp. Eczema. A Middlesex grocer brought his bright little boy of six or seven to 12 Diseases of me about two years since : the boy had double cataract. Two years previously she had had eczema of the vulva. with much nocturnal irritation. but that was cured by the doctors at the Hospital for Diseases of the Skin. sol. "Oh! that zinc ointment. Said the father to me : He used to have an eruption on his head." Double Cataract from Suppressed Eruption.effusion on the brain. but totally failed . when her physician gave the Skin. 3* in alternation. cured it with bran water and vegetal diet. and was quite blind. Dr W. who gave her a saline draught. and an ointment con- . A lady of fifty came under my care in October 1879. her Graphites $ v and Mer. In September of the same year she went to A . and the grandfather sobbingly cried. Ophthalmia. the child died. and the local doctors were already nonplussed.

and advised constitutional treatment. and so did the patient too. salt beef caused con- 14 Diseases of stipation and faintness. when her husband called on me. lead. her skin was dry. Ossified Heart from Suppressed Eczema. that came very soon after the eczema was cured. and she had not had any return of skin disease or ophthalmia. He could not undress without laying a sheet on the carpet. \ 5 ing he was in the habit of using the coal-shovel to shovel them up. I called in a consultant of very great experience and world-wide reputation.taining zinc. — in fact I never saw a worse case. and she was low-spirited. as the quantity of dried scabs that fell off was really considerable : after undress- the Skin. but in vain . I explained to her that the ophthalmia and the eczema were really the same thing. or more than five years thereafter. This cured the eczema. and we treated the case together . 6 trit. She came to me for an inflammation of right eye. cured her constitutionally. on June 2nd. she was constipated. to which she consented. She was worse at the sea-side. He . he grew rather worse than better. I treated him to the best of my ability for a long time. In the year 1874 I was attending a country squire for eczema of the whole body of a very bad type. Natrum Muriaticum. and other remedies. and mercury.. 1885. to be applied at night. but the eczema defied us.

although your eczema is indeed almost as bad as ever. I acknowledge that I have quite failed to cure your eczema with my ' constitutional treatment. I solemnly warned him against local measures. and mineral waters. — in fact was first felt not long after his being cured by Mr S. and then he called to consult me about difficulty of breathing that had been slowly creeping on for several years. washes. saying : " Remember this. i 7 the patient in question told his skin doctor of my warnings anent his eczema. I should have said that the Skin. such as baths and ointments. I am sorry for you. though they all declared that . now deceased. but you yourself never enjoyed better health in your life. Mr ." He went to an eminent special skin doctor. of eczema. and his physicians all failed to cure it. Then his dyspnoea became a serious matter.sent for me one day. and this gentleman made light of it. declaring that it was my incompetence to cure that deserved attention. and in a few months was cured of his eczema by means of ointments. and you mean to be rid of its outward expression. You are disgusted with your foul disease. and used such language about me professionally that my patient would not allow my name to be mentioned in his house for nearly three years. come what may. For four years I did not see him.' at which it 1 6 Diseases of pleases you to poke fun. weary "constitutional treatment" of which I was always telling him. said he was sick of the weary.

" He seemed quite well to look at . No medicines did him any real or permanent good. When Nature was prevented from speaking as eczema by Mr S. We had a post-mortem examination of the body. and to spas. about the genesis of the degeneration of the internal organs. too. "to please his wife. and then he died of his disease. and shrinking of the liver. At last he found that an extra glass of champagne. and found ossification of the heart in about two-thirds of its extent. to my mind. all upset his breathing. she used the internal parts wherein to deposit the irritant material which produced inflammation and ossification of the most vital organ — the heart— rendering a continuation of its functions im- . Finally he came to me. and the doctors' skill failing. his lungs were all right. but his heart was irregular in its action. he went to the South of France. a tiny incline. there was no trace of his former eczema on his skin . No doubt. in fact. but all to no purpose — his breathing slowly and surely grew worse. the gentlest game of croquet. and then c 18 Diseases of to lung specialists.'s skingagging.his lungs were sound. and there was neither apex-beat nor radial pulse. I cured all his symptoms over and over again. 19 seous and quasi-osseous adhesions to the diaphragm. with os- the Skin. though many wellchosen remedies relieved his various symptoms .

Such are the facts. the . p. Bazaroff. 433) the case of a highly scrofulous soldier. A few years since I was reading in the London Medical Record (April 15. and with it the trachoma. that — " Dr Porfiry G. The erysipelas disappeared in seven days. but the following excerpt from the 20 Diseases of very orthodox Record is so consonant with my views.possible. that I here interpolate it: — Disappearance of Psoriasis and Trachoma after Erysipelas. the regimental surgeons resolved upon placing him on the roll of 'unfit for service. 18. 1886. of Belyi Klutch. the patient was suddenly attacked by erysipelas of the face and head. p. severe trachoma of long standing on both sides. and enlargement of the cervical and submaxillary glands. Striking instances of internal affections being cured by some outward. who was admitted with general psoriasis the Skin. There was nothing peculiar either in the course or in the treatment of the disease.). 155.' About that time. et seq. and such my reading thereof. records (Proceedings of the Caucasian Medical Society. acute manifestation constantly recur in medical literature. In these pages I rely purposely on my own observations exclusively. however. or other. 1885. The treatment failing to relieve any of the patient's extremely obstinate and troublesome affections. aged 22. 2 1 vulgaris of two years' duration. No.

Tiimpovsky recently published a case of disappearance of ascites from erysipelas (see the London Medical Record. 11). the minor 3). Nos. [Dr M. Pasternatzky. of Professor J. Petersburg Med. p. J. Dr F. details two cases of the disappearance of hepatic ascites under the influence of typhus fever. Dr Schmidt published . however. leaving no trace. and who got rid of the symptoms after an attack of erysipelas of the face and head. 199). 38-41. T. 43. January 1884. Dr Mishtolt's patient was cured by the same disease from sarcoma (Id. May 1885. also. the the Skin. an improvement in his general state. Tchudnovsky's clinic. &c.. Dr K.. 1883. In the Vratch. Koltchevsky saw a case of trachoma cured by erysipelas (lb. Wochensch. a mild attack of scarlatina was followed by a steady diminution in the bulk of the head (in a month the large circumference lessened a centimetre. Dr Bazaroff mentions. July. No. Two months later. in a week an "unfit" became quite a healthy man. 1882. who had suffered from daily and nightly incontinence of urine..' the author adds. 296). p. a rather obscure case of a young soldier. with congenital hydrocephalus of the progressive kind. In the St. aged 22 months.glandular swellings and psoriasis (first of the face. of two months' duration. p. 23 child died from general convulsions. a boy. ' In fact. and a case of renal dropsy cured by relapsing fever. then — after two hot baths — of the remaining parts) 22 Diseases of also disappeared. In another patient.

with fainting. subsequently. 26 Diseases of . but organic and organismic. I give it just as I received it. I had seen the lady in town. and will let it tell its the Skin. and I was unable to take any food without causing sickness . 1886.m. alternate heat and chill. This was followed by sickness. and sent for the nearest homoeopathic doctor. Eczema with Internal Metastatic Symptoms. as before . and lasted nine days. I was taken at 5 a. own simple though instructive tale : — "A few days after I came to see you I was very unwell — at the usual time — which commenced four days too soon. April 18th. —Rep?? All this surely proves that topic disease is not local. &c. I was very weak and in my room for some days. I was so ill that my brother became anxious.24 Diseases of a case where erysipelas of the chest had caused a rapid disappearance of an enormous pleuritic exudation. and I received the following letter. A few years since — May 1886 — I met with a very striking example of the intimate connection that exists between a skin affliction and internal symptoms. On the fourth day. The sickness continued frequently until he arrived about 1-5 p. Sunday. took brandy just in time to prevent going quite off.m. and prescribed for her on April 13th.

28 Diseases of . for ten days I could scarcely use my hands. and they are still very sore . His sight was good until he was about two years old. The following case is very instructive. and the eruption extended to wrists and neck — right side of neck below the ear being swollen and tender. and its power of expressing itself in the lens if compelled to retire from the outer integument. but as soon as I recovered it broke out again and was worse than ever on my face. then in the left one. a boy of four was brought to me from the South of England. the joints of fingers are also swollen. "After a few days the fingers and backs of hands became very badly cracked . 27 This lady had previously had catalepsy on various occasions. when he had incipient cataract in the right eye. Eruption on Scalp — Cataract. Towards the end of the year 1880." the Skin. and the cracks healed. large patches of spots constantly running with heat and irritation. as showing the nature of a skin affection of the head (scalp). and at the age of three he was blind. and considerable irritation ."During this time the eruption on hands and face disappeared. and she consulted me for the neurosis principally. Both face and hands were much swollen. there is less tendency to heal than usual.

— i. for whereas he formerly looked straight out before him fixedly at the light. and cry in his sleep again as he had previously done. and he began to see! His mother reported that he altered in his gait. the eruption disappeared. and medicines. He further astonished his parents by remarking that there was a certain colour in the Skin.I elicited the following noteworthy anamnestic point: He used to have great irritation of the skin ever since he was a few months old . although I had given to the parents.e.. an eruption came on his skin. 29 the painted ceiling. and so did the returning vision." After the first medicine which I ordered him. when between eight and nine months old he was treated for it with ''sulphur ointment. There was also slight but evident change in the opaque lenses themselves. the boy went quite blind again. no sooner did my medicine begin to bring back the eruption to the scalp than the mother forthwith applied some zinc ointment she had in the house ! The zinc ointment did its work very promptly and effectually . The further course of this case . now he bends forward. that the cataract was a direct consequence of the cured (suppressed) skin affection from which the child had suffered. as my opinion. laugh. He also began to talk. pale green. Now. and re- 30 Diseases of mained so. still. a lotion. and more particularly on the scalp.

then came the cataract. stood in causal nexus. with Remarks on Homoeoprophylaxis" (London and New York. still it is nevertheless a the Skin. in due dose. viz. I may be allowed to transcribe a few cases from my little treatise. due. Although I hold that vaccination. fruitful source of skin diseases. which is again cured by operation. and he cured me. and the allopaths could not touch it. Mr J . — that is to say. came under my observation on November 3rd. which illustrate this point. " I am not a homoeopath. we live in an age of wisdom and enlightenment. : — Pustular Eruption. he believed. Orthodox medicine cured the eruption with ointment. from small-pox. and he volunteered the information that ever since his second vaccination he had been subject to eczema. 1884).showed most conclusively that the opacity of the lenses. entitled " Vaccinosis and its Cure by Thuja. and the scalp eruption. a hale-looking. Said he. but twenty years ago I had eczema. . on the homceoprophylactic principle. they had a common cause." And he went on to say that he believed in homoeopathy for 2. so I went to a homoeopathic doctor. Vaccinal Dermatitis. to a bruise. middleaged London merchant. On the left leg he had a pustular eruption. protects. Truly. He had also eczema of the ear. 1 881.2 Diseases of skin diseases.

shewed that the chin manifestation was from .vaccinated in July 1 88 1. and the patient subsequently sent word by his brother to say that his skin was the Skin. 1 8. He came in a week nearly well . and he himself too busy to shew himself as he had promised. the pustules had at once begun to wither. set. ^^ well.The eczema of twenty years ago was soon after the re-vaccination. however. and had a singularly ugly. and she had a very "fine" arm. three times a day. The gentleman who had done the re-vaccination was of opinion that Miss had got some of the D Diseases of vaccine virus on to her finger-nails and inoculated herself by scratching. The sequel. with "lymph" direct from the calf. Four three-drop powders to the two dozen. by the local surgeon. To take one. Pustular Eruptions. repulsive aspect. but in less frequent doses. dry on the tongue. The operation was very successful. thirty miles from London. covering its whole extent and involving the lower lip. at her parents' country residence. was re. IjL Tfoijce Occident alis 30. The Thuja was repeated. But as the " arm" was just at its greatest perfection she got an eruption on her chin. Miss . The thing was very unsightly.

it was around the left nostril. but against this was the fact that the arm had healed already. as every one knows. and it had depassed the natural course of vaccinia by at least a fortnight when I first prescribed the Thuja. 36 Diseases of This is the brother of Miss (observ. to have a test. 35 the history of the disease : it ran through its natural course and diedI thought that to myself at the time of prescribing it . I gave her brother. but the eruption on the chin was not to be got rid of. but more spare. which is also. and instead of being on the chin. Now.within. In a fortnight she was out and about. and only some diffused redness of the skin remained. I say. and I gave Thuja 30. who also had a somewhat similar pustular eruption (and who had been re-vaccinated at the same time). The surgeon had ordered applications. because it was just the Skin. The young lady had to wear a dense veil to hide her face when driving out. iv. but no scar or thickened skin. two of which were vaseline and zinc ointment. it might be objected to this case that the Thuja had nothing to do with the disappearance of the eruption.) . apparently homoeopathic to such a pustular eruption. But to have a test. She was brought to London for my advice. I gave this brother of Miss Antimonium tart..

1882. Mr . The larger patch on the right side was about the size of a florin. That they were causally connected with the re-vaccination admits of no doubt whatever. The patients went into the country.e. two little spots of matter. at the edge of the nostril. did not " take. $7 cination marks. and below it. a London merchant." I sent Thuja 30. from the vaccine virus.The two eruptions were similar. Had also an old hordeolum on his right lower eyelid. the second time. Hairless Patches on Chin. to be treated for some roundish hairless patches on either side of his chin. and from the same cause. his arm is also not well. which began four months ago. i. came under my care on July 27th. and he has had four little pocks about the vac- the Skin. twelve years ago. If anyone can account for the cure of these two cases independently of the T/mja. and he was reported well in ten days." was her expression. though the boy's was comparatively trivial. the size of a large pin's head. nose-bleed . and of the same age. and in two or three weeks' time the mother wrote that the young lady was quite well : " the medicine soon put her right. but the boy had "a bad cold in his head .." . 3 8 Diseases of Has been twice vaccinated . having something the look of 's chin . left side of nose swelled and red . his ingenuity is greater than mine.

fy Thuja Occidentalis 30 (4 in 24). 40 Diseases of This case is not without practical importance. Sept. the one on the left side nearly gone. Rep. Thus Kunkel observed both a very weak growth of hair and an excessive growth. Still it might have been so. he believed. 1 jt/i. in my opinion. dry on the tongue.existing white bald patches being completely covered with hair. Has. the previously . the old hordeolum also gone. let it stand as a doubtful case of vaccinosis for what it may be worth. — The bald patches are gone . — but there can hardly be any reasonable doubt as to the cure of the case by TJmja. as effects. as the hair is very powerfully influenced by the vaccine poisoning. The closely-shaven beard is now uniform. I give this as an interesting cure the Skin. Here it might not be amiss to observe casually that the presence of sties on the eyelids is often. inasmuch as hodiernal medicine hands over a sty to the . — The bald patches are smaller. To take one. at bedtime. because of other points in his clinical history. Oct. especially in wrong places. a symptom of vaccinosis. but I am not very sure that the disease was really due to vaccinosis. a very bad coryza — (?) organismic reaction. of vaccination. 7th. Therefore. apparently. 39 by TJmja.

The conceit of the orthodoxly ignorant is truly sickening. and Nasal Dermatitis. in the form of a saddle. was brought by her mother to me on October 28th. about twenty years of age. This . but she could not remember whether the nose was previously affected or not. roughly. — in fact.chirurgeon's art . In trying to trace the skin-affection back to its real origin I ascertained 42 Diseases of that the patient was re-vaccinated six years ago. 4 r scaly nasal dermatitis. it was likely to mar her future prospects very materially. or like that due to dyspepsia or to tight-lacing. The nasal dermatitis was. weens herself so very much superior to scientific therapeutics usually called homoeopathy. but a pimply. Patient had a very red pimply nose. poor old dame. Acne of Face and Nose. 1882. but appearing more as facial acne. the Skin. Of course this state of things in an otherwise pretty girl of twenty was painfully and humiliatingly unpleasant to her and to her friends. The pimples of the nose and face used to get little white mattery heads. A young lady. not like the red nose of the elderly bibber. She also complained of obstinate constipation. which extended from the cutaneous covering of the nose to that of the cheeks. and all the time. more especially as it had already existed for six years and was making no signs of departing.

fy Thujtz Occidentalis 100." ]£ Thuja Occidentalis 30.e. though it is far from improbable. — Pimples of face decidedly better. The re-vaccination and inflammation of the skin of the nose were referred both to six years ago when she was in Switzerland at school . Constipation no better. reaching into the quick. but patient could not remember which was first. " She is wonderfully better. the bad nose or the vaccination." The skin of the nose is normal.vaccination was unsuccessful. That Thuja cured this case is incontrovertible . and for this she remains under treatment. the Skin. November 30th. Very . and in addition to these indentations there are black patches on the under surfaces of the nails. she says. "The last. i. it did not " take." I ask the young lady which powders did her most good .. — The face is free ! Her mother gratefully exclaims. but that it was a case of vaccinosis is not quite so certain. On December 22nd. Diseased Finger-nails. 1883. January 3rd. Nose less red.re. a young lady of twenty-six came under my care for an ugly state of the nails of her fingers. 1882. Naturally a lady of her age would not be indifferent to the state of her nails. but the constipation is no better. 44 Diseases of These nails are indented rather deeply.

rouses latent disease for . — Has continued the Thuja 30 for just about three months. but it also. by no means must be attributed all skin affections. Looking upon this diseased condition of the nails as evidence of chronic vaccinosis. The eruption on the back has not been modified. it does cause numerous skin diseases without a doubt. following closely or remotely in the wake of vaccination. with the result that within a fortnight from commencing with it the black patches under the nails began to disappear. the Skin. but I thought this much of a case of nail disease would be of some interest. The foregoing cases sufficiently exemplify the causal nexus existing. I ordered her Thuja 30 (one in 6). Has been vaccinated three different times . The black patches have existed these eighteen months. However. between vaccination 46 Diseases of and diseases of the skin. 1883. On her shoulders there is an eruption of roundish patches forming mattery heads.slight leucorrhcea occasionally. the last time two years ago. and for this she remains under treatment . to the pathogenetic effect of the vaccine virus itself . and frequently. She had chicken-pox as a child of eleven. as I believe. and the more so as it is not easy to demonstrate drug-action on nail growth at all. and the nails have become diseased since this last vaccination. 45 March lgth. The indentations are notably better. and there is now no trace of them.

I think his head is cooler. but these drops could not be used after the first instillation. which w r as cured by internal (probably tonic) and external treatment. Had ringworm of the scalp in the summer of 1879. this report came — " My boy is still improving with his eyes slowly ." A little later I received a letter to say that the boy had " ringworm on his scalp again ! " That was the last I heard of him. they have not that large glaring appearance . The connection of cataract and various skin affections has long been noticed and written about by numerous authors. and notably worse since the measles in the summer of 1880. and then of the 200th. After four monthsof Sulphur 30. not suffice. The father says he is "wick. 47 had given some drops to be put into the eyes." which he explains means lively. Had been under an oculist of repute. but the doctrine is not accepted by many." Has been delicate all his life. The failing of his sight was first noticed in 1881. look more natural. Ringworm of Scalp — Cataract. of course. with opacities of both lenses. who the Skin.which anti-vaccinial treatment will. as they " made the child like a dead'un for days. from Yorkshire. At the beginning of 1883 a boy of six was brought to me. On this . and he has not been 48 Diseases of excited in his sleep . .

the eye looks natural again. Young man. pupil was enlarged and immovable. the lids and conjunctiva were somewhat reddened. From it I quote the following. he had an attack of intermittent fever. 26th. There APPEARED A NUMBER OF FURUNCLES on the arms . 48). Sulph. and 29th of August. bearing thereon (pp. August 9. 20. as if it had been punctured by a needle . 1880. 6. several e 50 Diseases of PIMPLES ON THE FACE AND ARMS. A short time since he discovered that he could not see with his left eye. which he cured with pepper and whisky. The eye had a dead look . in the middle of the lens there was an opacity. the Skin. of which he got rid by internal and external use of medicines.* which. Sulphur 6 . which was repeated on the 19th. and on the 3rd and 23rd of September. Later. has lately been translated into German. * " Curability of Cataract with Medicines. 47. through the kindness of my learned friend. On holding the hand quite near to the eye he could dimly discern the fingers. Sight better." London and New York. August 2. set. Dr Goullon. had had the itch one year and a half ago. 49 Scabies — Cataract — Furuncles. of Weimar. and he sees as well as ever .point I take the liberty of referring to my treatise on Cataract.

Emmerich. In Raue). " Arch. everything appeared in a place different from its real position. Dr Bernard also notes that in several of the cases habitual perspirations re-appear. the Skin. 52 Diseases of smoky appearance. 105. so that he was unable to use his tools properly.. as in the forming stage of cataract. He received Sp. and he now saw everything in the right position. ten drops three times a day . — (Fr. Dr Becker treated a carpenter who had been affected for some time with tetters about the face. p. the old eruption re-appeared.." XIV.before. The pupils presented a misty. Need we any further proof that cataract is a cutaneous affection ? Tetters. 51 which latter is cured with Spirit Snlph. Schcenfeld). Crusta Lactea. Sttlph. [A 2d ore. . which disappeared after a while without his taking any medicine. but otherwise his sight was not improved. I will only give the fifteenth at this place. ill. but his sight became impaired. . or a cutaneous eruption either appears or re-appears. The fifteenth is this : Crusta lactea disappears and cataract supervenes. 7-78) — Dr Bernard gives an epitome of fifteen cases from Ruckert's Kliniscke Erfahrungen. And then (pp.

and she then took twenty drops Ac.—K rheumatic inflammation of the foot set in. at the time of menstruation. Her eyesight became much better. was affected a year and a half ago with the worst kind of itch.Then on March 22nd. (Pp. Deposit in urine like lime. could read better. Silic. was administered in doses of ten drops twice a day. July. after which she improved very much. and continued taking the same remedy. aged 20. 54 Diseases of Scabies — Ague. 100) — M. was administered in doses of seven drops daily. and . and this was followed by a great improvement in his sight. He perspired easily. Suppressed Perspiration of Feet.. three times a day. Silic. 98. her eyes became worse again. Silic. 99. The same gentleman treated a lady whose feet generally perspired the Skin. 53 freely and then became very dry. she could only read large print. and thereafter she noticed that her sight became affected in such a manner that everything she looked at appeared to be enveloped in a cloud . Two months later. and had much perspiration about the feet. tinsmith by trade. Aq. Aq. The accustomed perspiration of the feet returned again in about a month.

— ("Arch. " XIV. Treatment. and some itching of the skin. pupil dilated and immovable . 55 Six days after the first dose.. From September 13th to September 23rd. — A staring look of the left eye . however. suddenly he noticed. six doses of the same. many pustules appeared on the face and arms. — August 2. Sometimes he had tearing pains in the left eye. in the centre of the lens there was a slight opacity . in the meanwhile his eyesight improved so much that he was enabled to distinguish large letters. 105. the Skin. his sight was almost extinguished. 6 . p.subsequently with fever and ague. and the affected eye was as useful as it had ever been before.. — Sulph. that he had become completely blind in the left eye. Emmerich.) Of the connection of the skin and the lens embryologically and pathologically I will say no more. v. from August 9th to September 20 3rd." 56 Diseases of . merely referring those interested in the subject for further information to 44 Curability of Cataract. after that the skin became clear again. Symptoms. to which he paid very little attention . furuncles on the arm made their appearance .

The second. with the same kind of cutaneous patch on the sternum." I have four such cases in my mind at this moment.The "Sternal Patch. the most notable benefit being derived from Carduus Marice in five drop doses of the strong tincture given three times a day. and general uneasiness. 57 were associated an enlarged liver and a cardiac affection. I find . of the size of a woman's palm . with arcus senilis as a concomitant. He came to town to see me at odd intervals for about two years. I remember. Under 58 Diseases of date of January 31st. I treated him antipsorically and organopathically. and very notable heart trouble. with it the Skin. evidenced by palpitation. and was then discharged cured. The first I will narrate is that of a mayor of a large town in the north : — He had a patch of brownish lichen on the sternal portion of thorax. In my case-takings I call it the " sternal patch. which I have several times found co-exist with heart disease and swelling of the left lobe of the liver. 1883. I would like particularly to refer to a patch of eruption on the skin covering the lower part of the sternum. systolic murmur. Here the ease and comfort brought by the Carduus Marice were very striking." One often meets with liver affections connected with cutaneous manifestations. was a Manchester merchant.

soon made me right . and I consider him vastly improved. 59 The third case was that of a New York merchant. and Acidum Oxalicum 3* and some other remedies. and during the past two years has had. the patch went away in a fortnight . the Sk in. to see if the cure proved permanent. had had it for years. — " It had a most marvellous effect . I found his liver very much enlarged. Vanadium 6. I advised him to remain awhile under observation. but he hurried out of my room in great glee." This gentleman has remained under my care. and his life — speaking commercially — worth 40 per cent. calling upon me at odd times when in town. Bellis Perennis 1. and I never saw him again.in my case -book these words of the enthusiastic patient. as he seemed to get no better from the treatment of his New York advisers. more than previously. and he came in a week declaring himself quite well. I gave him Cardtms in like dose to the foregoing. who suffered from liver. besides the strong tincture of Carduus. The fourth case in which I found the sternal patch and enlarged . and also the before-mentioned sternal patch of skin disease. and had come over to Europe to consult a physician. Aurum Metallicum 4.

where this patch co-exists with hypertrophied liver. and palpitations of the heart. — an officer in the Royal Navy. but her chin had become . when the relations of the various cutaneous regions will be recognised as constituting the very base the Skin. together with the giddiness. this sternal patch will be understood to indicate " liver and heart. and in which the affair has a specific air about it. and went to Mr . I might say the same of a fifth case. was that of a London lawyer. I foretell that." Chin and Throat Affections. and the heart too. and she used gargles and other local means on his advice. giddiness. in the future. Sarcognomy. 61 of medical and medicinal diagnosis. She told me she had originally relaxed sore throat. At the commencement of 1873 a young lady came from a distance to consult me in regard to her throat. who cauterized it a good many times. but it needed a course of antipsoric treatment to finish the cure of the patch of diseased skin.6o Diseases of liver. probably inherited. Here the liver got well. but she then got a series of quinsies. Her throat became better. She had thereafter nothing to complain of in her throat. Then came recommendations of changes of air and tonics.

throat again cured. of course. twentv-four years of age. but who treats his patients generally locally all the same. The absurdity of Specialism. Renewed cauterizings . and so. as this young lady's chin and throat persisted in playing hide and seek. So she went on for six years under the most manysided surgeon of the day. was brought to me in June 1885." Well. absolutely unmindful of the twaddling dictum about " gleams of a fruitful suggestion. that I might give my . For these she returned to the same gentleman. 63 else. who writes so very philosophically about the pedigree of disease.62 Diseases of the seat of some nasty spots. the silly treating of the throat and chin had led to nothing. and found that the real seat of the constitutional disturbances giving rise to the symptoms in the throat and on the chin was neither in the throat nor in the chin. who cured the chin with ointment. she felt constrained to try something the Skin. After her chin got well. her throat again troubled her. but in the ovaries. I went into the case carefully. Probably it would not be easy to obtain a more striking example of the absurdity and futility of ordinary local treatment usual with most of the so-called specialists than this : — Miss Nora . Then the face and chin were covered with spots and pimples afresh.

but it did no good at all. took her to a gynaecologist of great the Skin. and following thereon. Her father has hay fever. No one has attempted to take a view of her entire economy as a living unity. and the other is treating her hayfever. very bad leucorrhcea. With all this local tinkering and pottering and domestic messing. Now she is actually under two specialists . measles. and also bronchitis. She is also subject to a very severe form of nettle-rash . for varying periods and to various places. and also one of her brothers. her mother is also treating her " nettle-rash " with domestic homoeopathy. who performed an operation. Then she was sent away for her health. she is no better. The treatment she had was at first that of their ordinary (homoeopathic) family physician. My treatment was not sought at that time. 65 reputation. Twelve years previously she had scarlet fever.64 Diseases of opinion of her case." and the discharge is very profuse and very clotted . Is it any wonder that all these fruit- 66 Diseases of . at her menstruation she suffers " excruciating agony. Ever since then she has been deaf. who. She has been subject to hay fever these twelve years. In addition to these two learned brethren. She then was treated by the family doctor for her bronchitis. failing to relieve the dysmenorrhea. one treats the ear.

less measures have made the poor
girl almost bewildered ?
Relationship of Skin Affections
to Internal Organs.
As illustrating the general nature
of skin affections, and their intimate relationship with other organs
and parts, I will narrate a part of
the history of a lady of rank, now
40 odd years of age.
Originally, some fifteen or more
years ago, she had badly ulcerated
legs, and her local surgeon cured
them quickly with an ointment.
Soon after this cure — of which
both patient and doctor were very
proud — she had ulcers on the
eyes, which a late eminent oculist
cauterized, without being able to

the Skin. 6j

get rid of them ; then a very noted
London physician saw her, and
said he thought the ulcers on the
eyes were due to the too rapid
cure of the ulcerated skin of the
legs, and ordered her to use
vinegar compresses over her shins,
with the object of inducing fresh
ulcers ; but, at the same time, he
ordered her to use golden ointment to the eye ulcers, — which
golden salve forthwith cured them.
The vinegar compresses produced
an eruption on the legs, as they will
on most people.
How this unctuous physician
could give an opinion that the eye
affection arose from the quasi-cured
leg ulcers, and then forthwith order
an ointment to cure the eye ulcers

68 Diseases of
on precisely the same lines, might

at first sight seem strange, only
one knows of him that he mistakes
a jumble of second-hand clinical
tips for laws of therapeutics.
Presently the poor patient found
that getting rid of corneal and conjunctival ulcers with golden ointment was anything but a cure of
the disease essentially, for the next
step of the progress of the disease
was in the eye, not on it. The
inside of the eye not lending itself
to unctuous handling, it was sought
out with the — knife ! The operation
had to be repeated several times.
Well, it's a long, weary story, and
patient is nearly blind, and almost
eyeless these several years.
I was listening to this history

the Skin. 69

two days ago, and the poor lady
exclaimed, " Ah ! if I had but
never used that golden ointment."
Eczema — Enlarged Ovary —
Chronic Oophoritis.
It is about two years since a
lady of 40 came from a distance
to see me ; she was an invalid,
and had not had a month of good
health for many years. I found her
suffering from chronic oophoritis of
the right side, which recrudesced
every month at the menstrual
time, and which was often accompanied by circumscribed peritonitis.
The ovary was enlarged to about
the size of an orange, was very
tender, and was clearly attached
by post - inflammatory adhesions

jo Diseases of

to the peritoneum. The dysmenor-

rhcea was very terrible, and the
periodical peritonitis was quite an
illness. She had leucorrhcea, and
her visage told the tale of great
and repeated sufferings. Treatment has quite cured her, and she
now leads an active, useful life ; but
that is not the point I wish to dwell
upon, but rather upon its origin.
I found from her history that
she used to suffer from eczema ;
she went to Erasmus Wilson, who
prescribed " zinc ointment and
other things," and quickly cured
it (the eczema). Patient herself
denied "ever having had anything
the matter with her skin ; " it was
her relations who told me of the
old eczema.

the Skin. 71

People have certain preconceived
ideas of diseases : if they know you
are suffering from "liver," they
smile ; if you have anything wrong
with your brain, rendering you
insane or vicious, they are afraid
of you and lock you up in an
asylum ; if you have anything
wrong with your skin, they shun
and despise you, little weening
that the same or a like morbid
essentiality may be at the bottom
of them all. And hence, when
questioned about their "skin,"
people not infrequently stop short
of all the truth.
Constitutional Nature of Lupus.
It is very curious that even
where some eminent and thought-

72 Diseases of
ful dermatologists admit the constitutional nature of a given skin
disease, they still adhere to the
local treatment. For instance, it

He regards lupus on the whole ' as a sort of cross produced by tendencies at once to scrofula and cancer. " Mr Jonathan Hutchinson seeks. fifty years ago: — 'Were we called on 74 Diseases to declare our opinion of the essential character of lupus.e. and contends for a clinical 'lupus family' of affections. — i. and is allied especially to scrofula." Professor Smith says : " Turning now to the pathology of lupus. we should say that it is an intermediate patho- . What may be termed the Anglo-French school.is now thought and taught by some advanced men that lupus is a tuberculous disease of a bacillary nature. As giving the latest views on the pathology of lupus — the most terrible of all skin diseases — I should like to quote freely from Dr Walter G. 73 "1.. from peculiarities in the patient's skin and his morbid tendencies. with Auspitz. while it receives many modifications.' It is interesting to note that a similar view was put forward as novel at the time by Dr James Houghton. that lupus has a constitutional foundation. Smith's paper in the February (1885) number of the " Dublin Journal of Medical Science. in one or the other direction. to widen the signification of lupus. we find two chief views prevailing as to its aetiology — the Skin.

g. for the nature of lupus erythematosus is still a matter of controversy.. by the blending of these two diseases. many of their peculiar characteristics are lost. lepra. likewise leprosy and tuberculosis . and tuberculosis). as represented by Kaposi. " The following remarks refer particularly to lupus vulgaris. while he places lupus among the infective granulomata. those dependent upon the action of an organised virus capable of reproducing itself in the body {e.logical state between cancer and scrofula. But notwithstanding Kaposi and the arguments he adduces. admits that ' the exciting cause of J 6 diseases of . " The question.. is it so with lupus ? " Ziegler. — i.' " 2. but constituting a state in which. that lupus will find its true place the Skin. then. partaking somewhat of the nature of both. in other words.e. converging evidence has been accumulating infavour of thedoctrine that lupus is a branch of the tuberculous stock . 75 among the chronic infective diseases of the skin. — that lupus is an exclusively local affection. and hence constitutional treatment is rejected as useless. and Veiel places it among the superficial inflammations of the skin along with eczema and impetigo. syphilis. or. The Vienna school. is this — Syphilis has a specific virus.

' and Neisser. with Fagge and others. to which I am largely indebted. clinical. and Germany. bones. if it can . the Skin. but certainly the association of lupus with scrofulous glands is sufficiently common here. they have arrayed against them the testimony of numerous skilled observers in England. yS Diseases of " Now. who recognise the points of resemblance. and in which he upholds on general pathological grounds the tuberculous nature of lupus. histological.lupus is unknown. Clinical Aspects. since the fundamental unity of scrofulosis and tuberculosis has been established both on clinical and experimental grounds. since neither I nor others have hitherto succeeded in demonstrating with certainty the bacilli of tuberculosis in lupous material. I have witnessed the development of lupus secondary to suppurative strumous inflammation. France. yy " i. and joints with lupus. — Upon this point suffice it to say that while Kaposi and his followers are unable to see any connection with scrofula or tubercle.' He presently adds that he holds the forthcoming proof to be only a question of time.' Similarly Hyde — ' The causes of lupus vulgaris are absolutely unknown . in his admirable article. I cannot give statistics from my own cases. " The question may be conveniently studied from three points of view — viz. and note the frequent coincidence of cheesy affections of the glands. and. says : — ' But I cannot yet adduce the exact proof of this connection.. and even ridicule the proposition. and experimental.

— Careful investigations have shown that no essential difference can be established between a caseating miliary tubercle and a lupous nodule. The pathological processes in each are the same in kind. and consequently a more gradual destruction towards the centre. that it is seldom found in combination with general tuberculosis. an argument will be furnished for bringing lupus into the tuberculous family. 8 presented well-marked physical signs of phthisis. " It is quite true that lupus is rarely observed in several members of the same family (Fagge). Histological. and Mr Hutchinson has pointed out that phthisis is not unfrequently observed the Skin. M. one of the foremost French dermatologists. insists upon the connection between lupus and tuberculosis. but differ in So Diseases of degree. Thus in lupus it is less acute and less intense. among 38 patients under his care for lupus in St Louis. "2. with peripheral healing and formation . occurs in phthisical subjects . In June and July 1883. Besnier. 79 in the families of those suffering from lupus. Dr Tilbury Fox states that lupus.be shown that an intimate relation exists between lupus and scrofula. and hence we get slower development of the inflammatory granuloma with a richer development of vessels. which sometimes exhibits ' the exact appearance of tubercles ' (Ziegler). and that we have no evidence of hereditary or of direct transmission in the human subject. in many cases.

and examining the precipitate that falls down. Demme. Yet it repeatedly happened that when in a number of sections not a single bacillus appeared. "According to Unna. — i. But the decisive proof — the demonstration of tuberclebacilli in lupus material — remained to be given. the bacilli G 82 Diseases of are observable in quantity by partially digesting hardened specimens. sections taken close by exhibited one to three bacilli. Pfeiffer. and Doutrelepont had published records of the occurrence of tubercle-bacilli in lupous skin.of spindle cell-tissue. and in the tubercles of animals inoculated with lupus.. . Koch never found more than one bacillus in a giant-cell. following up Friedlander's anatomical investigations. and it was not long before Neisser's prophecy was fulfilled. "In 4 cases he excised parts of the Skin. examined seven cases of lupus of unimpeachable diagnosis. In 3 cases he examined scrapings only of the lupous tissue. cicatrix (Neisser). The tubercle-bacilli were found sparsely in each of the 4 cases. and in the other 43 sections had been made. The tubercle-bacilli in lupous tissue are so isolated that in 2 cases the bacilli were not found until in the one case 27 sections. " For direct microscopic investigation he used only the excised bits of skin. Dr Robert Koch. and only in the interior of the giant-cells. 81 the skin.e.

In two cases he succeeded. Microscopical examination of the two successful cases by Pfeiffer (Ehrlich's method) exhibited Koch's bacilli. Experimental. Positive results such as these. — Koch made inoculations from all his seven cases into the anterior chamber of the eyes of rabbits. 11 3. Ehrlich. bacilli have the Skin. which were several times utilized for successful inoculations on animals. and likewise forbids the hope of deriving material help in diagnosis from the use of the microscope. and in those animals which lived long enough. 83 not been demonstrated in connection with lupus erythematosus. by general tuberculosis. more .But Koch states that his experiments were finished for some months before their coirmiunications were published. From one specimen (excised from the cheek of a boy ten years old) he obtained pure cultures. "Again. and others. duly recognised as such by Ziegler. So far as I am aware. " The curiously sparse occurrence of the bacilli in lupus suggests a ready explanation of some of the negative results of other histologists. In every case this was followed by tuberculosis of the iris. Numer6us tubercle-bacilli were found in these inoculationtubercles. Pagenstecher made three inoculations from conjunctival lupus into the anterior chamber of the 84 Diseases of eyes of rabbits. in one he failed. coupled with those of Schtiller and Huter.

85 skin excited by the tubercle-bacillus. " Two years ago Vidal and Leloir could assert that ' no results have been obtained from the experimental inoculation of animals with lupus. but there is a quantitative difference which is accentuated by the more unfavourable conditions of nutrition in the colder skin. ulcerating scrofuloides. the evidence is strong of the unity of cause in tuberculosis.g.than counterbalance the negative results announced by Cohnheim. there is onlyone tuberculosis of the skin. joints.g. and even with analogous skin affections — e. lupus. . and the relatively rare involvement of other organs. "Genetically. The bacilli of lupus and tubercle are probably the same qualitatively. then. and scrofulosis.' Gathering together. The localization of the bacillus in the skin. Complications with tuberculous affections of other organs — e. constitute the peculiar features of lupus as compared with other forms of tuberculosis.. and others.. Their non-occurrence does not contradict the tuberculous aetiology of lupus. "In short. the foregoing evidence. then. 86 Diseases of the Skin. are frequent. although we do not yet know the special determining conditions of each case. we seem to be guided to the conclusion that lupus is a tuberculosis (scrofulosis) of the the Skin. bones. Hansell. yet tuberculosis of the skin assumes other forms than that of lupus (Neisser). glands. and we may say that while lupus is always tuberculosis of the skin.

but this innovation is scarcely likely to be approved.Ewald even goes so far as to suggest Morbus Kochii as a clinical term for this group of three. by way of analogy to Morbus Brightii. The subjoined table may be useful for reference : — -s 73 O p £l $ 4 '% ° c/2 P rt P "-S +3 o ^ g 3 ■h h o m ^0 ti G ^ .

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8 rt £> o 5 5j ^ C/2 3 ^ ^ $■ "•6 P <u >% .o .

for he says. "It will be generally admitted that local treatment is the Skin. And Dr Smith is true to this view. then it must be simply a local affection. W3 }H ^ <D JJ> SS Diseases of "If asked for a definition of lupus. 89 . I would say it is 'a very chronic new cell-growth.CL. one would naturally say that if the aetiology of lupus be. always ending by scars. really to be referred to the same bacillus as that of miliary tuberculosis. and the disease would be cured by external local treatment. depending upon infection with the bacillus tuberculosis. as Dr Smith avers. with or without ulceration. and usually developing brownish-red nodules.' " Now.

the more important. 91 . though I have sometimes seen the morbid process stopped by very severe cautery or excision .. It is very difficult to cure lupus by internal medications. tuberculosis) virus . and sometimes even permanently. "chiefly iodine. though even these severe measures commonly fail completely. but it can be done ." Although Dr Smith believes lupus to be dependent upon the tuberculosis bacilli.e.. and perhaps the most that can be done in this way is by strengthening the the Skiit. and that Dr Todd Thomson was extremely successful in temporarily.. which were materially benefited. while local applications were sparingly used. he saw numerous cases of ulcerating lupus in the wards of St Louis' Hospital. in reference to the internal medication of lupus. for I have never seen a single case of lupus really cured by local treatment. Warburton Begbie as mentioning that many years ago. arresting the ravages of lupus." But this is not my experience. and some apparently cured. and Dr Smith himself quotes Dr J. — ■ undoubted improvement following the use of certain remedies. we cannot maintain that as yet we know of any specific against the lupus (i. by the administration of 90 Diseases of cod-liver oil in very large doses. On the whole. still he says : — ". iron and arsenic conjointly. when a student in Paris.

what relation does the lupus-bacillus bear to the lupus-virus ? or are we to consider bacillus and virus the same thing ? If lupus is ever to be cured it must be cured by internal medication in some direct way by a medicament. and yet I read in the London Medical Record under the heading of "Case of Generalized Favus" (August 15. 26. standing in some relationship to the whole lupous process .constitution to increase the capacity for resistance of the body against the spread of the germs of the disease. that— " Professor Kaposi (Wien. Case of Generalized Favus." We see the Professor is slightly befogged in his notions as soon as he touches the art of ctiring ! Tout comme les autres ! Now. or by medicaments. or is not. 1884) exhibited at the Medical Society of Vienna a remarkable case of favus in which the disease was present on many parts of the skin. it is certainly Favus. 93 . If there be any one disease of the skin more than another to which one might accord the quality of being local and external. due to the same bacillus as tuberculosis . Oct. to pretend to cure 92 Diseases of it by killing the bacilli is like the grand old way of catching sparrows by putting salt on their tails. 1885). Medizin. Presse. and if so. the Skin. either lupus is.

just over 50 years of age. A lady. I n the exudation. came to consult me with regard to a tumour in her the Skin. 1885. Moreover. and it is probable that the acidity of the gastric juice was sufficiently diminished to admit of the fungus developing. covered with necrosed tissue 2 millimetres thick. Of what nature was the inflammation of the contents of the popliteal space ? Tumours and the Skin." In this case it would have been eminently instructive if Professor Kaposi (who treats almost every skin disease as a local affection) had given the treatment of the defunct Favus-bearer. It was not found in the intestine. however. That the treatment was local is almost certain. The fungus appears to have provoked the disease of the stomach. In the neighbourhood of the pylorus there was a patch of infiltration about the size of a 2 -franc piece. spores and mycelium were found analogous to those present on the skin. who found that there was favus of the stomach. An eminently instructive case came under my observation on August 13. — an explana- 94 Diseases of tion which. Professor Bamberger refused to admit. one very naturally asks. 95 . The man had been a drunkard. the autopsy was made by Professor Kundrat."The patient having died of phlegmonous inflammation of the popliteal space.

" Precisely. but I thought I'd just mention it. I dare say that has nothing to do with it. but my skin has been so much clearer since the lump came. with coincident neuralgia of right ovary.right breast. as such. But about a year before the date of her visit. Well. though on the skin. she fell with her right breast against a bedstead. to avoid which she came to me. 97 succeeded in showing that diseases of the skin are really diseases of the system. And so here. In the near future I hope we may have . But it is not about this tumour. She had in vain used washes. this lady had suffered from red angry pimples on her face. If I have in the foregoing pages the Skin. — in fact I have very few pimples now . the systemic nature of skin diseases. so the parting observation of a patient often throws a strong light on a case. ". doctor. — it is the antecedent constitutional condition of the patient that bears on my present thesis. viz. It is very funny. As she rose from her chair to go. and a few 96 Diseases of months later she noticed a hard lump in her right breast. and back all her menstrual life. that I wish to speak. she said.. chest. with a consultant. . urged immediate operation. I having successfully treated a lady friend of hers for a similar affection. . and baths for the skin . and her family physician. then my task is accomplished. ointments. chin. Just as postscripts are said to contain the real raison d'etre of a given epistle. only temporary ease and amelioration resulted.

honey.some definite conception of the correspondences that undoubtedly exist between certain regions of the body surface and the internal organs. etc. this great thinker says." So that. and also why. acne. by external means. when these diseases are driven in whence they came. perhaps. and other cutaneous eruptions. cucumbers. ''Certain other peculiarities of diet. in regard to the etiology of skin diseases. cheese. 99 Fletcher cites. result from cold drinks taken when the stomach is hot. be able to see why certain cutaneous diseases affect certain parts preferentially. are a frequent exciting cause. pomphylix." In his " Elements of General Pathology. in what condition is the stomach left ? and which is the locus morbid the stomach or the .. and it is thus that psoriasis. 99. the kernels of fruits. at least in such cases as the Skin. etc. if the treatment is to be local. and then we shall. independently of general organismic interdependence. all which seem to arise in these cases from sympathy with the stomach ." p. certain internal organs have to bear the brunt of it.. of urticaria. pityriasis. 11 98 Diseases of Fletcher's " Etiology. as the use of cream. according to the idiosyncrasy of the individual. lepra.

skin ? I am myself very much disposed to regard what Fletcher calls " the idiosyncrasy of the individual " as a pathic idiosyncrasy such as. their origin. for the most part. The Daisy is here commended in Haemorrhage. As I consider the observation of wider practical importance. Nurnberg. not in the skin itself. for example. 101 (with Hoffmann's Remarks). Dys- . exists in those persons who are subject to hay fever. seeking to show that Diseases of the Skin have. In this little volume I am. Acne from Cold Drinks. before all things.. I will give the source of my own knowledge. and anent this I wish here to quote an interesting and instructive experience of my own of the curative effects of the common Daisy in complaints that are due to wet cold. I refer to " D. Johann Schroeder's Pharmacopoeia Universalis " the Skin. acne of the face. but are essentially cutaneous manifestations of some more ioo Diseases of or less remote organic or organismic wrongs. 1748. Bellis Perennis against the Ill-Effects of Wet Cold in the Overheated. Thus Fletcher mentions Acne from Cold Drinks.g. — e.

. as a " herrliches Wtcnd kraut" internally and externally. Further. bruises and the like. in nocturnal cramps. pains in the joints. for he declares that an account of this action of the herb should be written up over all gates and doors for the benefit of the poor harvesters who in the hot harvest season get ill from partaking of cold drink. as shown by experience. for lameness . in his Kriegs-Artzeney.entery. as will be seen later on. fevers and inflammations . — i. Christoph Schorer. An ordinary commendation of Arnica reads almost in the same terms. rheumatism (and hence called " Gicht kraut"). — for the effects of falls. it would appear that Mindererus. — " This herb is useful to such as have 102 Diseases of partaken of a too cold draught of something. angina pectoris. gives similar testimony. its effect in such cases he the Skin. of being useful in all those terrible and dangerous accidents that arise from having drunk something very cold when the body is in a heated condition. as a vulnerary. cannot sufficiently praise the Daisy in such cases.e. in his Medicina peregrinantium. for it possesses a peculiar quality. but what I would specially call attention to is this. and he says that German mothers were in the habit of using it for their children as an aperient. and says that he cured . 103 affirms is remarkable." This important point I have verified. blows. and so prompt that amelioration sets in at once.

. hot weather. that Bellis perennis is curative of complaints due to drinking cold drinks when the body is heated.two men of dangerous coughs. sometimes less. Arnica for falls and bruises . 105 an eruption of great bumps in the face about every three weeks. for instance. at one time barely to be seen. 1879. This eruption coin- . sometimes more . 30. EFFECTS OF SUDDEN CHILL FROM WET COLD WHEN ONE IS HOT.e. I offer the following instructive Case. at another looking like Phlegmonous Erysipelas. 104 Diseases of Now we may add this other. a^t. Miss P.e.. and gave the following history: — Ever since she was 12 years old she had been subject to the Skin. Of the use of Bellis for the ill effects of cold water suddenly brought into contact with a heated body. We know from experience the immense value of certain generalizations in the treatment of disease." — i. that were due to their having drunk something cold when they were heated. as. and so on. I will call it Habitual Periodical Facial Dermatitis. Hypericum for wounded nerve tissue . came under my observation on September 24th. with emaciation. — i. Dulcamara for the ill effects of damp. And Schroeder affirms that it will cure dropsy due to drinking too much in "dog days..

and discharged so much 106 Diseases of that her mother had to tie a handkerchief round her neck to prevent its dropping on her clothes. Bowels regular." Her whole face and ears were covered. but they never did me one bit of good ! " She has often a terrible sinking at the stomach. 107 tion. and some days thereafter she broke out all over head and face with an eruption " just like small-pox. She was indoors eight weeks with it. bad pain across the hypogastrium at the beginning. and I reasoned thus : It arose primarily from the effect of cold water applied to the heated ." she exclaims. I was greatly struck with the history of the case. and every size between. The present state of the face is just this : — The right cheek and right side of the face generally are occupied by a red. as if she had a large hole wanting filling up. and while thus greatly heated she fell head foremost into a brook. some of the angry protuberances being as large as big peas. Going back to its origin. menses very painful — a hot. tuberous erup- the Skin. as to the remedy. Now. and all sorts of things. " Since then. she was one day out in the fields in sultry weather at hay-making. and some only papules. together with a pressive headache at the top.cided with the commencement of the menstruation. I elicited the following curious fact : — Just before her twelfth year. Nosologically: Periodical Dermatitis. " I have had any amount of medicines and greases.

of course. and going ttp to the throat. This is. viz. but the same idea underlies it. that Bellis was considered a capital remedy for such as had partaken of cold drink when the body was overheated. Therefore ft Tc. All my observations tend to that conclusion. an ex- 108 Diseases of tension of his application of its use. How do we know but cold drink taken into a heated body produces internal erysipelas ? If. beginning in the pit of the stomach. But considering Bellis perennis as analogous in its action to Arnica gives a fair reason for its use in this case. this idea be found to bear useful therapeutic fruit. 22nd.. — Three drops in water three times a day. in the end. She is actually menstruating (it began yesterday). 109 has not had a speck for the past fortnight or more. it will doubtless be found in strict conformity with the law of similars. a queer shaking. — Face is quite well . the Skin. and she has now. and that brought Johannes Schroeder's observation to my mind. as Arnica both causes and cures Erysipelas. and that must surely be very like drinking cold water when overheated. precisely as if she had been . S.surface of the body (or rather conversely). but only after food. which began eighteen years ago ! ! Her bowels have become confined. It left gradually. and her face is quite free for the first time at the beginning of the flow in her whole menstrual life. Bellidis per. Oct.

as we know of no other remedy in our vast pharmacopoeia that possesses it . last poorly time not a spot ! She came occasionally for two or 1 1 o Diseases of three months to report herself. This property of the Daisy is the more valuable. The Bellis did not affect either the sinking at the stomach or the pressive headache on the top of the head at all . Of course. It is to be noted that these two symptoms were of much later date than the facial dermatitis. I gave her Sulphur 30. but I think it shows that the Daisy is a notable remedy. my reasoning in the foregoing case might be faulty. 1 1 1 any experience do not need to be told that the ill effects of drinking cold drinks when the body is heated are very serious at times. as the idea is sudden wet chill to heated stomach or body surface. early in December. Nov. and always inconvenient. and come again in five weeks. and. and this virtue of a common weed lying everywhere at our feet deserves to be made very widely known. beyond myself. and thus I can affirm that it so far remained permanently cured. when these two symptoms also disappeared. — Has continued well of the eruption . one drop at bedtime for twelve days. People of the Skin. To take two drops only once a day. so. 2\tJi. I believe no . Of course it is not confined to the drinking.running fast.

Quite lately I have information of the cure by Bellis perennis of a severe case of Facial Acne. produced originally by patient's rushing about in the cold air while her face was in a very heated condition. harvesters. or have drunk cold liquids. . for the Facial Dermatitis was one that would certainly be classed as a Disease of the Skin. being heated. I regard this peculiar property of the Daisy as eminently important.D. for I have. 1 1 3 dilate on the remarkable therapeutic virtues of the Daisy. found it an eminent curative agent. and internal treatment alone cured it. apposite. and ask all who may read this to make it known.E. tourists. — O. I should like very much to the Skin. have had a cold ducking.one is acquainted with it. as the conditions here are identical. when they. but this is not the place. soldiers on the march. and this little clinical tip ought long since to have been published. so that it may be available for such as travellers. I would recommend it also in the acute and chronic dyspepsia from eating cold ices. however. for it may be a good while before U2 Diseases of another lover of the fair Daisy stumble against old Schroeder's generalization in a humble receptive mood. Most of what I here write has been lying in a drawer of my writingdesk for years. This much is. in such cases.

skin doctors are working great evil in the world.PART II QBJECTIONS to the first edition of this little treatise were raised largely because of its essentially theoretical character : well. not very much signify what views of aetiology and pathology the treating physician Diseases of the Skin. and wrong should everywhere be crushed like a nut under a steamhammer. whose object was to point out how entirely wrong are the commonly accepted views as to the nature and cure of cutaneous affections. and sadly need enlightening . and their almost universally accepted views and practice are sound and in accordance with the facts of disease. If the position which I take up be the true one. while. that is really a compliment to the writer. Dermatologists ! I ask no mercy. 1 1 5 may have . but I submit it makes all the difference in the world when we are dealing with skin diseases. if they are right. Sine Ira et Studio. perhaps. on the other hand. then I must be in the wrong. " facts we are all advocates of Said a gentleDoctor. We all subscribe to this saying. man to me one day. and not to show that X cures Y. but in the search 1 1 6 Diseases of after light and real apt to become merely our own pet notions. sine ira et studio. In some cases of disease it may. I . as I give no quarter.

I will give just a few of the results of my reconsideration in this second edition. I do not know about your facts/" With that he ran off laughing. it is getting much worse of late years. so far as my own casetakings in my own practice were concerned. is out of print. you ought to have been an advocate .have read your book . published in 1886. hot. A lady of 73 years of age came to consult me in the month of March 1885 for loss of vision due to double cataract. In dealing with cataract I always go at once to a consideration of the skin. and the epidermic scales light- . Her lenses were opaque and of a milky colour. Though her skin had never been other than dry and scaly. Here they are. I will consider afresh the whole question of Diseases of the Skin from the standpoint of the organism as an entirety. In her movements patient 1 1 8 Diseases of is exceedingly slow. and here the find was instructive : her skin was very thick. the clinical material made use of in the first edition came down to the commencement of the year 1885. spending as much as two hours at her very simple morning toilet. Well. notably on the extensor surfaces. and my publishers are asking for a new edition. and as my little book on the subject. 1 1 7 way. dry. By the the Skin. and scaly. and at this point I will resume my task. Case of Ichthyosis. with long cracks here and there. and was clearly of opinion that he left me at full length in the dust. thought I.

Psor. This lady has continued under my observation up to the present time. Graphites 30. there has been a very distinct improvement in her skin. c. and her various ailings have been from time to time much relieved as well. — just a case of chronic diffuse hypertrophic keratosis. But. on the other hand. Bryonia. . 1 1 9 There were temporary improvements in vision here and there. being just able to find a large object . Ichthyol 30. Pulsatilla. and so would now be in her 79th or 80th year. She was nearly blind when she came to me. nor so much cracked. During the five and a half years she had from me many remedies. Borax.coloured. TJmja. Galium aparine r r . Psoricum 30. Natrum muriaticiim 30. Calcarea hypophosphorosa 3*". 30. Juglans cinerea. Baryta mur. 3* and here — August 1887 — there was very distinct amelioration both in the skin and lenses. Platanus occi- i2o Diseases of dentalis i x . Betula alba 0. though not particularly pearl-like. And considering the age of the patient and the very long duration of the affection. — Calcarea fluorica 6. Lactuca vir. the Skin. and the lady has still a very small amount of vision. I think the improvement in her skin very noteworthy indeed. Aconitum 3* Aurum mwriaticum natronattmt 3^. which is neither so thick nor so scaly. 3. thus with a little groping and feeling with her knees she could find a chair to sit upon.

inferring that as the case was not cured. i 2 1 more comfortable. and at 78 life to this lady is what remains to come after 78 ! It may not be much. that the lady's discomforts have been greatly alleviated . according to our respective ages. We must remember that what we call life is to each individual of us a varying quantity. The Betula alba patient credited with rendering the skin much the Skin. the whole thing was a fiasco. that at jS her skin is actually much better than it was at J2> J while at y^ it was getting worse and worse. The fact that the lady's span of life is dwindling has nothing to do 1 2 2 Diseases of with the clinical evidence of curative results from drug-action.The remedies that were of very distinct advantage were Barium and Plat anus. but complained that it affected the upper part of the body only. medically speaking. not diminished . alleviating an old patient is. But I pointed out that what results from the treatment is strong evidence of beneficial drugaction in a very inveterate case at an advanced age . A friend of this aged lady spoke slightingly of the treatment of this case. or rather the greater the age of the patient the more remarkable the evidence. but it is life to her : in other words. and under the Platanus for several months also her skin admittedly underwent considerable improvement. Under Barium for several months patient increased in vigour and well-being. her skin at y$ is not getting worse but better.

sixty-four years ago. or generally in this country. deeply pigmented. when it keeps her awake .. and also at night. nevertheless. Patient. having left her birthplace and came to this country at the age of 6 years. though English and 124 Diseases of long resident in England. scarlatina. it is much worse in the cold weather. I mention this point because I do not remember ever seeing a case like this before.e. diminishing much in the warm weather of summer. is. of West Indian birth. dry and itchy. 1890. Severe Case of Eczema of Sixteen Years' Standing — Elephantiasis Labiorum Vulvae — Life-long Constipation.because the patient benefited may not have long to live by reason of advanced age. The irritation was very bad . worse after sitting or walking much. scaly. Patient enjoyed good health. — " At six I well remember when All folks seemed old at ten. came under my observation on October 9th. and now for some time past has what has been called dry eczema of the vulvar lips. and hence presume it cannot be common in London. shiny. and there is also a patch of "dry eczema" over her right eye. Both the vulvar lips of the right side were hugely enlarged. She com- . and pertussis. — i. reddish in spots." the Skin. 70 years of age. and has never had anything beyond measles. well-preserved lady. and appeared as a big flap of elephantine nature. A strong. telling me she had very severe eczema for the last sixteen years.

October 30. the third one having been unsuccessful.e. and she had been costive all her life . and finally gave it up as a constitutional peculiarity. There had been in all three vaccinations." R Sabina 30. — i. " Dr Bell (homoeopath) treated my constipation for long.. — Not any further improvement. January 8. and patient exclaimed. German. 1891. allopathic and homoeopathic. — all have tried at my costiveness in vain. 125 seemed to account for so severe an affection in an otherwise strong. has been always in the habit of going six or seven days without any motion." $ Maland. Nothing the Skin. and now the bowels act so well. and was in 1 87 1. subsequent to this third unsuccessful vaccination.plains of being chilly. French. . the mass softer. the labial swelling is less. November 20. 126 Diseases of December 18. — The bowels have acted twice every day. IjL Vaccininum 30. healthy lady. — The little patch of eruption over the eye is well. fy Thuja 30. 1890." The elephantine skin of labia steadily improving. and then art and physic had to do it. " I feel quite different. CC. The eczema had first obtruded itself upon patient's attention sixteen years ago. — Patient cried out to me on this day : — " English.

under which the bowels went back. — Well . 1891. is noteworthy. Skin affection improving. medicus curat. came to consult me for roughness of the skin of the face. objectively the skin is quite normal. 5. On February 10. " I have never felt so well in my life. March 19. 30.Feb. and hence we may conclude that the cure is a perfect one. — Vaccin. May 21. bowels act quite regularly and comfortably . and though patient feels not quite comfortable at the vulva. an unmarried lady. Case of Acne and Swelled Neck. Natura \organisimis~\ sanat. well on towards 30." R Nux 30. — the remedies used being all given internally. — The cure holds good. — this cure. and 12S Diseases of not only so. . — Skin healing well . and tells well for my thesis that skin diseases are of constitutional nature. the Skin. bowels not quite so comfortable. 127 Feb. I say. but in dynamic doses (and infrequently). and acne. Nine months later. bowels act comfortably. At the end of November the skin continued quite normal. and must be so regarded and treated. 26. IjL Vaccinatum 30. And this radical cure of an old-standing ailment in a lady of 70 years of age.

nor did she make much ado about the rather profuse expectoration of phlegm. "Those powders did a wonderful thing for my skin : it went quite clear. neck restored to its pristine shapeliness . the unshapeli- 130 Diseases of ness having changed : the jaw had become well defined. and not long after this she was engaged to be married.e. Thuja 30 for a month distinctly lessened the size of the glands (submaxillary and tonsil). shapeless." The "horrid neck" was made up of a one-sided enlargement of the neck. 1000. but cough and phlegm were not touched." July 21. tonsils normal . so that the side of the neck appeared "horrid. they only came in very cold weather. consisting of a very much hypertrophied submaxillary gland and tonsil of the same side. it was not so very bad. Said she. though less. and neck and face ran into one another. with some puffiness of the surrounding areolar tissue. 1 89 1.She did not mind her cough. and as for the Skin. The tonsils had gone down. and in . — Patient is quite well . left submaxillary enlargement gone . skin clear . the jaw-bone line being lost." — i.. I then went up to Bac. and thus neck and face no longer ran into one another. She did not even complain of her enlarged tonsils or leucorrhcea. was still considerable. while the left submaxillary gland stood out by itself. 129 her chilblains. "It is my rough skin and this horrid neck. Bacillinum C. was followed by much improvement. but the quantity of phlegm.

for many years married. — Patient continues quite well. 131 was to the effect that I was dealing with vaccinosis and scrofulosis bordering on tuberculosis. as I learn from her mother. The flat ulcers in the labia and nymphae had plagued her years ago. Lady X.the early autumn the marriage came off. 132 Diseases of extending at times as far as an inch and a half on to the circumvulvar region. A lady of 50 years of age. but childless. with a few pustules here and there. not the least of which was vaginal and vulvar irritation. Here {May 18. IjL Tc. mur. 3* three drops in water twice a day. and with advantage. May I put the pertinent question to any dermatologist or surgeon in this wide world of ours : What would you have done in this case ? August 1892. P latin. Ulcerative Eruption of Vulva. but when it came into the common integument it took more the form of eczema. came under my care for troubles connected with the climaxis. In a month the eruption had materially diminished. My reading of the whole case the Skin. and the vaginal discharge had entirely ceased. . and been cured (silenced) by cauterization. 1887) Lachesis was ordered. as well as a very extensive ulcerative eruption all over the labial and vulvar region. having lost its pustular and purulent character.

Golden ointment. but I commonly specially warn my patients against all ointments and lotions whatever. I used no local application whatever.July 7. If in any of my cases herein recited any local applications are used. and it is very difficult to prevent their being used. the remedy having to be once subsequently repeated : in all. 1887. my respect for the quality of such treatment is small indeed. four drops in a tablespoonful of water night and morning. so far as I am aware. 3' r . There has been no return. the Auric salt was taken during about thirteen or fourteen weeks. Zinc ointment. once for all. Citrine ointment. And here I may state. that I hardly ever order local applications of any sort in cutaneous affections. Not only so. as I find that Goulard's lotion. nat. may be found in very many households. 133 fy Tc. — The thing has returned. but I believe that in no case herein communicated was any 134 Diseases of local application whatever used. This compl etely cured the eruption with its concomitants. and the lady continues in excellent health and condition. and when I read of the homoeopathic treatment of skin diseases whereby ointments and lotions play a part. It is wonderful how people will cuddle and fondle the ointment . The use of remedies applied as ointments or lotions is absolutely bad. the Skin. Aurwn mur. and the like. the fact will be stated .

and two or three cases of symptoms of the rim of the hairy scalp. both being of the cutaneous covering of the chest. The patient here referred to came to me on December 22. remedies having cured his neu- . which were distinctly of the same nature. I often think the use by the homoeopaths of their Calendula cei'ate or ointment comes dangerously near the thin end of the wedge of the vulgarly-conceived putty-and-paint treatment of the medicine of the schools. he came to be treated for a maddening neuralgia he had picked up on the banks of the Nile . Although the Vienna School classifies this rather rare affection with eczema. 135 pot . 136 Diseases of Case of Pityriasis Rubra. And what does it all amount to? A pat of pig's lard. It is almost incredible. the vault of whose heaven is still ringing with the echoes of the wonders of vaseline and lanoline. A powerful peer of this realm and a great Nimrod. with flesh as hard as nails. but the discovery of a new fat for an unguental excipient is an event of the first magnitude in the dermatological world. and " Regular Medicine " would be indeed badly off without its grease-pot and clyster. I cannot see myself whereon the classification is based . 1885.the Skin. but I have only had to treat two typical cases of it.

and which the doctors took for a form of syphilis. procured this erythrinus for me. "you cured that long ago with that big bottle of stuff you sent me. and I. all more or less circular or segments of circles. I should say the big patch was composed of a series of smaller patches. *37 ralgia he showed me his chest.. When I inquired of him about the "red patch on his chest.. ordered as follows: — IjL. — the ounce . for nearly five years. and came out with a peculiar red rash that became chronic. Erythrinus 1 §j\." said he. with his wonted devotion and disinterestedness. in some of the Pacific islands. five drops in water night and morning. F.." "Oh.. I did not see the patient after for about two and a half years — viz. off and on. 1 89 1. which was the seat of a big patch of red pityriasis that he had had for a number of years.. but the pityriasis rubra remained . — the precise number I do not know. I think — many years ago. I saw him.L. and gave him a not inconsiderable portion of our Pharmacopoeia (and our Pharmacopoeia is not small — see Allen's " Encyclopaedia of Pure Materia Medica!"). 1889. ate Diseases of of a fish called erythrinus. and prepared it homceopathically. One day I was reading in an old German book that some sailors — British.S. on March 23.e. Dr Alfred Heath.the Skin." i. Pityriasis rubra. Tc.. September 1.

particularly up hill. 139 The second case of pityriasis which I treated with this Erythrinus is greatly improved. — who is not cured. That it is not eczema I am very sure. So that when an individual has an eruption on his chest. palpitation. but the patch of pityriasis became twice as large. 141 . in a tablespoonful of water three times a day. as I ascertained from an indirect but very reliable source. The father of the gentleman who was cured by Erythrinus had had syphilis. The father of the second case died of what seems to have been aneurism of or near the heart. irregular heart-beat. It may therefore be worth while to ascertain whether pityriasis rubra be not a syphilitic manifestation in the second generation. It is worthy of note that the second patient to whom I here refer. but by no means cured. — came to me originally 140 Diseases of for heart disease characterized by distress in the heart region. and much distress on walking. and at another time two drops. and finally five drops. This vicarious phenomenon between heart and the skin of the thorax I have observed over and over again. This cured the heart rather slowly.bottle of Erythrinus 1 . the Skin. For this cardiac affection (which the regimental surgeon said would be fatal) I prescribed Aurum muriaticum 3* at one time three drops. and is still under my treatment. he is not wise the Skin.

now in one part. A lady of position. so-called. and just over the arch of the aorta. but an eruption. now in another. the " Sternal Patch " is in the lowest third of the sternum.to let any skin specialist treat it from the narrow standpoint of the specialist." By the way. nearing 70 years of age. I think. more or less grave. She . What are the internal pathological conditions corresponding hereto ? Without doubt such exist. The " Sternal Patch " is not a brown. not so much in the kind of eruption as in the fact that when it vanishes from the surface. symptoms of heart disease. taking her suddenly. of very abstemious habits and a strict dietarian. this thoracic pityriasis patch is rather to the left. See hereanent my remarks upon the " Sternal Patch. The more one really studies skin 142 Diseases of diseases the more one is struck with their habitats. the importance of this eruption lies. Case of Violent and Severe Attacks of Arthritic Urticaria. without being really cured from within. 143 to allay the furious itching. which are often constant and characteristic. rather to the right . liver mark. and have also a definite significance. lest heart disease supervene. and compelling her to hasten to her own apartments to apply hot wraps the Skin. at once supervene. had been for years subject to violent and severe attacks of gouty nettlerash.

have passed large quantities of sand. and had obtained a little temporary relief sometimes. but I persuaded her to take it ( Urtica urens 0). And for the common manifestations of pure the Skin. she exclaimed. 145 gout. it is my sheet-anchor for years past. that's no good. five drops in a wineglassful of warm water three times 144 Diseases of a day . I could fill a little book with . and only consented to try again at the earnest solicitation of a friend. considering herself cured. Urtica urens is a very notable splenic. and I have repeatedly noticed that patients. I have tried that under Dr . " Oh ! that's your tincture of nettles . and. in the manner just described. and then discontinued its use. so that she had given up all hope for long. and in several instances such patients have been alarmed. and my dear old friend the late Dr Hilbers also gave it to me. When she took my prescription into her hand. and with its aid I have often cured ague. much to her surprise. it did her so much good that she continued to take it for some months. while taking Urtica ur. never having passed any before in their lives. In connection with this case it is worth remembering that Urtica had in old times quite a reputation for gout and sand.had been under most of the betterknown homoeopathic physicians in England one time and another." She persisted in it that Urtica would do her no good. but not much.

1887. going about in fear and trembling. and revels in this July heat. it was thought the final break-up of the constitution was at hand. slight neuralgia only . no fainting attacks. came to me on July 12. quite broken down in health . though she felt her nerve symptoms very much. This lady is an amateur artist. and has also suffered from urticaria. She is intolerant of cold. Hence I started off with Thuja 30.cases in proof of this statement. a good deal of neuralgia in the left side of head and face. She formerly had variola and measles. 55 years of age. spleen very much enlarged (affirmed that she had had ague every spring until she was nearly thirty years of age) . A married lady. — Was quite well till the Skin. The most prominent and most distressing symptom was perhaps her attacks of faintness and her inveterate and severe dyspepsia. Nervous heart- 146 Diseases of beat . tongue now thickly coated. But the fact that she had been twice vaccinated seemed to me the most proximate and least questionable therapeutic indication. 147 two days ago ! No vomiting . . She was afraid of being alone. August 11. and paints a good deal these many years. and wonders if her frequent attacks of vomiting have any connection therewith. childless. Dyspepsia — Vomiting — Neuralgia — Neurasthenia — Acute Eczema.

149 . and is. as the eruption dies away the locus turns brown . and had. the eruption is now worst on the hairy scalp . and patient very earnestly requests that she have the old powders again.The next most obvious point to attack was the greatly enlarged spleen and the chilliness. — The skin has improved a good deal. but she has "broken out all over with an eruption of water and matter. The neuralgia is bad again. Juglans regia 0. — Has a bad attack. Six drops in water night and morning. which the Thuja powders had so much benefited. on the contrary. IjL Ignatia amara 1. Five drops in water night and morning. no vomiting. So Thuja 30 was again prescribed in very infrequent doses. feels wonderfully well. — Much better. in fact. 1£ Ceanothus Americanus 1. now on these eight days. December 1. and there is a little eruption on the tips of her toes and fingers . — My patient came this day and bitterly complained that the Ceanothus had done no good at all. " And she now has ceased to be cold. l$c Tc. Never had any eruption other than the Skin. 1888. hot. 148 Diseases of January 17. February 19. March 27. she feels sick and dizzy. brought back all the old symptoms. moreover.

feels tired and bilious. Natrum muriaticum 6 trituration cured these symptoms. well. ] 50 Diseases of Case of Strumous Eczema in a Baby. and who was partly on the cursed bottle. — The cure holds good. Did I say cursed bottle ? I will withdraw the wicked word. Five drops in water night and morning. continues hypertrophied. One meets not infrequently with bad cases of eczema in babies that are apt to end in marasmus and death : the eruption in such cases is almost all over the body wetting. three times . and ask my readers to allow me to substitute for it . October 6. more particularly in certain more or less circumscribed patches. otherwise she is well and the skin is quite healthy. however. — Bowels costive. particularly at night. and patient was discharged cured. cured by Bacillinum CC. and complains very much of feeling shivery and cold. — Been sick again. many brown marks where the eruption was. Much better in all general respects. 1^ Urtica urens 0.urticaria till after she took the Thuja from me. May 8. I had such a case this last summer in a baby of only a few months of age. The spleen. I mean the strongest word of con- the Skin. ft Rep. 151 . and driving the poor little patients almost mad with irritation. July 1893.

. in infrequent doses. when one afternoon I was suddenly summoned into the country to see this poor bairnie. and now sleeps and feeds beautifully. I therefore ordered for my wee patient Bacill. Mother and nurse were at their wits' end to know how to keep the wet patches from sticking to the clothes. I had treated the eczema for some weeks with no benefit. Baby is much better. and its use was only partial. Hardly any sleep at night from the furious irritation. in any potency. or. whereof I have been in times past more than once the sorrowful witness ." I need only add that the remedy quite cured the case. Well. . the mother giving all she had. In one week the report ran : ". 153 . now well hidden behind his long beard. I then remembered that I once cured an elder 152 Diseases of baby-brother of this little patient of eczema of the scalp with Bacillimtm. CC. In this particular case the mother did her best. and a sorry sight it was. originally suggested by the ancient scars in their father's neck. but then I knew nothing of Bacillinum in high potency. so the use of the bottle could not be avoided.demnation known in our language. indeed. the Skill. Such cases are very apt to end fatally. fat-besmeared rags only sufficing for a very short time. and so remains. and the little lassie got quite well.

when he declared himself quite well in health and free from eczema. I saw this gentleman a year and a half later. but in eight days from its commencement patient returned to 154 Diseases of me. though it came very near doing so. the Skin. in a low trituration. Then followed Mercurius solubilis Hahn. I began with Platanus occidentalis 0. Latterly it has been getting much worse and more extensive. A month of Kali chlor. except the redness of the eyes. This did him some good certainly. prepuce. and eyelids and conjunctivae. and extends now to the penis. 155 . An American gentleman. but it would not quite finish the cure. iSSy. a gonorrhoea only being admittedly historic. but this was strictly denied. and patient considered himself cured. Inveterate Eczema. — Six grains of Aurum metallicum three times a day. 3*. May 21. for a very severe eruption on the skin — inveterate eczema— of many years' duration. There was a specific air about it.The patient in question had not at that period been vaccinated. came under my observation on May 14. This ophthalmia was cured hy Jequirity 3* six drops in water night and morning. and it was soon clear that we had hold of the right remedy. bitterly complaining that there was no improvement. 63 years of age. but not very much.

anal. A sixteen-months' old baby was brought to me by its mother on . and am just beginning to recognise its rather numerous varieties from the aetio-pathological standpoint. " Oh ! that tincture cured me completely. In the autumn of 1891 a gentleman of about 60 years of age consulted me in regard to a very severe form of eczema occupying the genital. and then I inquired 156 Diseases of of the skin trouble. the Skin. administered every night and morning. raw. and I did the same again four months later. shiny. and in part moist. and I shall yet have more to say on the subject : here let the simple narrative of the case cured by the hippurate of sodium suffice. I sending him enough to last a month. I carefully examined the parts. and patient continues in good health.Case of Gouty Eczema. The first two prescriptions did him no real good. 157 Lichen Urticatus. so on November 27th. I have seen and treated a good many cases of eczema." To be quite sure it was so. when he called to ask me to suggest a place where he might with advantage spend his holiday. The thins: caused him verv great distress. I found no trace of eczema on either occasion. I prescribed the hippurate of sodium in the fifth centesimal dilution in tendrop doses. 1891. and crural regions : the surface was red. scaly in part. I saw no more of him till the spring of 1892. perineal.

CC. Chloral hydrate and Urtica urens." Cases of wheals in the skin of young children are very common." August 30. and the irritation they cause as the sufferers get warm in bed is often almost maddening. — " Baby's skin continues quite well. till the cure is definitely completed. echoes from the paternal past. to be treated for wheals on its body that became much worse in the warmth of the bed : the distress of the child was great . as it were. 159 Where the primary causation is from the effects of vaccination. and so is also Bacillimim. when the dose has to be repeated once. The thing is cured root and branch. . But where the nocturnally appearing wheals are. or perhaps twice. Jamiary 13. as if they were making desperate efforts to escape from their tormentors. ft Syph. it got hardly any proper sleep. the Skin. and also Persicaria urens are very useful in such cases. I have known 1 5 8 Diseases of such patients toss and roll about almost every night. and not infrequently roll out of bed in their sleep.November 27. 1886. — "These little powders quite cured baby in less than a fortnight. 1887. recurring occasionally when a new tooth sprouts. nothing equals the remedy here named as curative. 18S7.

the Skin. A lady. Thuja occid. I carefully examined the anal region. Crop of Soft Warts Round the Anus. as we might call it. with erythema of the nose. Cupressus. as also several vaccinations. came under my professional care in the summer of 1890. . Vaccinatum. and of infrequent administration. and found that the ring of small soft warts had quite disappeared. or Malandrinum may be used. Sabina. and also the anus. or. in the 30th centesimal potency. indeed. 53 years of age.Thttja." Nasal Erythema. The nose was all red and swelled up. the inflammatory action not in any way extending to the cheeks. and on examining this part to ascertain the cause thereof 160 Diseases of I found a number of small warts arranged almost in a ring round the orifice. A gonorrhoea of many years ago. bat involving the right eye a good deal. and. 1 6 x dermatic rhinitis. Thuja generally sufficing . quite cured the dyspepsia. In fact. sufficed to constitute the diagnosis of Hahnemannic sycosis. Incidentally he complained of a most uncomfortable state of his anal region. " I feel all right there now. A middle-aged married gentleman came under my observation in the summer of 1892 complaining of severe indigestion of long standing: a good deal of epigastric distress and pain characterized his dyspeptic state. and I have required Acidum nitricuni in some cases.

Besides this eruption he complained much of chronic insomnia and failing memory. five drops in water night and morning for a month. and patient had visibly improved in condition. Under Thuja 30 the erythema was half gone in three weeks. and she tells me that she is subject to this ocular inflammation. but it had only taken three times. I first gave him the strong tincture of Fagus cup.. After two months of M 1 62 Diseases of the Thuja the eye was quite well. Anamnetically there is not much to note. the Skin. off and on. (See the pathogenesis of Kali die). for many years. five drops in water night and morning.. I put patient on Kali bichromicum 5. 35 years of age. Finding that the nose scabbed inside. 163 but after a month — viz. came to consult me at the end of x\ugust 1887 for a coppery eruption of his scalp that he had had as long as he could remember. and then patient was discharged cured. A single gentleman. on September 30 — he complained that he was . except that the lady had been vaccinated seven or eight times.patient is of opinion that the rightsided conjunctivitis was the startingpoint of the nasal erythema. Life-long Eruption on Scalp. the erythema still only half well.

November 11. 21 years of age. The eruption distinctly better. Cardtms Maries 0. fy Tc." and both he and I were of opinion that his hair had gone darker. December 12. Chronic Crops of Boils and Acne. — Eruption nearly gone . 1888. 1888. 165 . and two years later it still continued well. and also one on his nose. five drops in water night and morning. CC. Syp. — " I have slept famously. fy Spiritus glandium quercus #. They are worst on his nape and face . and since then I have no further tidings of him. the eruption bad . — sleepless.no better in any respect. at this moment there is one on the nape. forgetful. the spleen pains a little now . just entering a very important city firm. spleen large and very hard. insomnia quite a thing of the past. liver slightly enlarged . Patient is very rich and rather good-looking. A young city man. and it is therefore not astonishing the Skin. came under my observation on March 21st. He reported himself quite well of 164 Diseases of his coppery eruption on January 13. complaining that for the past six years he had been suffering from crops of boils. restless. There are also mattery spots — acne — all over his shoulders. his breath very foul .

There is also a kind of acne that is distinctly of arthritic nature. I subsequently often saw him with his 1 66 Diseases of younger brother. for 1 had not expected such a prompt and perfect cure. phthisic acne to Bacillinum . 167 for hippuric acid. also to Silicea and M aland . and the glands of his neck are visibly swelled. to Vaccinin. and Urea. when the acne is very pronouncedly pustular and scarring. acne from masturbation to Bellis perennis . much to patient's amazement. The study of the varieties of acne is highly interesting . Urine has a specific gravity of 1020. and this yields well to Urea 6 . and arthritic acne calls the Skin. and Variolinum . I had him about ten weeks under Thuja occidentalis 30. hippurate of sodium. indeed. The case was clearly one of pure and uncomplicated vaccinosis without the dash of consumptiveness that so often lurks behind severe acne. very infrequently administered. Answer : Four times. Broadly put. to my own. and. to the number of ten. vaccinial acne yields to Thuja occidentalism Sabina. in this variety pustulation is much less pronounced than in vaccinial acne or phthisic acne. and Ctipressus.that he had been under the professional care of the leading physicians and surgeons and skin specialists of London. Finding quite a goodly collection of vaccinial scars on both arms. and the boils and acne pustules all waned and went and came no more. and so know that the cure was definite. I inquired what number of times he had been vaccinated.

What a vast vista ! Ringworm (Herpes s. I must refer my readers to it for the fuller information which it contains. which is not merely a morphological simile. and these need all their pathologic simillima. but what I conceive to be its pathological simillimum. and not the parasitic fungi. and Tellurium. It is also published in America by Messrs Boericke & Tafel. The older remedies for its cure are Sepia. Sulphur. my own special remedy is Bacillinum in high potency. and may be obtained at any of their pharmacies. It is entitled "Ringworm: Its Constitutional Nature and Cure " (London. to really and radically cure they must be pathologically similar. but as I have written a little monograph on the subject.) This is a very interesting complaint. This is highly important. Not infrequently cases of acne are of mixed pathological qualities.and instructive. Soon after the appearance of my little work on Ringworm just . Remedies only morphologically homoeopathic to the acne-form only palliate . as almostall the great constitutional ancestral diseases show themselves in young persons in the form of acne. 1 69 is aimed at. and particularly so from the i 68 Diseases of biological standpoint . as the following narration will exemplify. In treating ringworm cases by Bacillinum it must be borne in mind that the constitutional crasis the Skin. 1892). Tinea Tonsurans.

e. they considered that she was worse. as he is a homoeopath . sleep. strumous girl to me. but the precious fungi on the head haunted the child's mother so. a very eminent London ringworm specialist. 171 I deal with the organism. or at any rate that the ringworm was . stunted. it was found that the head was much worse ! — i.referred to.. the number of parasites demonstrably greater. temper. I must confess. and appearance. There being more parasites." Well. In 1 70 Diseases of the course of about two months the improvement in the child's general health was very marked. the number of fungi was much greater . and therefore my plan of treatment was given up as a dead failure ! It did not occur to these good people that my standpoint is the very opposite of theirs : the Skin. The mother brought the girl. very handsome of him. and the parents were delighted . still she wanted to know from the said specialist whether the parasitic fungi were decreasing . The organism was admittedly improved. that was. and having taken her to him. and I put her upon Bacillinum and gave up all local treatment altogether. I claim that the child was visibly getting better. desirous of practically testing my treatment. " Here is a case after Dr Burnett's own heart. but you go and see what he can do. sent a very delicate. they deal with the parasites. saying. that although she was very pleased to admit the great improvement in the child's appetite. Tell him from me that I regret being unable to co-operate with him.

worse. Do mushrooms come in a clean new stable. what I say is. further. what I claim is that eventually they go altogether as soon as the organism is normally healthy. Now. Of course. that the parasites themselves are not the disease. or in a dirty disused one ? Do toadstools grow on healthy trees. although the patient was better in herself. and. That the number of the parasites and their spores can be kept down by external parasiticidal treatment I do not for one moment dispute . but probably actually beneficial as organismic scavengers. but are merely the trichophyton mould living on the surface of a diseased organism . or on decaying ones ? Which the Skin. I not only do not claim that the number of parasites and their spores decrease in the beginning of my treatment. and their function is to use up and get rid of such decay . existed first — the decaying wood or the toadstool ? Can you cure a decaying tree by killing the toadstools ? Fungi live on decaying matter. it must be obvious that there would be fewer parasites present on the head while 172 Diseases of it was being scoured twice a day than while the head was let alone entirely. I incline very strongly to the belief that not only are the fungi harmless to the patient. . and I am fully persuaded that the function of the trichophyton of ringworm is in harmony with this general principle.

in appearance not unlike the surface of a billiard ball. . But there is one point in regard to alopecia areata in which all the dermatologists and skin surgeons agree. I do not think the affection can be considered a common one. mechanically childish. is at the same time quite useless except in very simple cases.. and that is their treatment — viz. 174 Diseases of Alopecia Areata. and a cow could live the life of a whale.It is inconceivable that you can better the health of a child by cleaning the ringwormy mould off the surface of its body. This is an affection of the hairy scalp principally. then fish can live in the air. and besides being well-nigh universal. circular patches. or. if so. particularly as to whether the decalvation be of epiphytic nature or not. active irritants applied to these bald patches. and all the skin specialists and all the favourite irritants of all the dermatologists of the wide world cannot cure it. This treatment is the Skin. bald. Authorities differ a good deal about it. sometimes painful. Given a good stiff case of alopecia areata. It is equally inconceivable that you should be able to keep ringworm alive on a healthy individual . though of course a few cases of it constantly pass before us. 175 simple. and consists of shiny.

Hughes also calls attention to Teste's singular experience with Aloes. 176 Diseases oj In alopecia areata the only sound plan is to heal the patient rather than the alopecia. these 39 cases) which he brings forward without coming to the same conclusions he has arrived at himself.Hughes names Phos. Lycopodium.. altogether 39 in number. and considers the second-named specific in the syphilitic form. What the real nature of areata baldness may be is still a moot point. We shall not lose time if we inquire into this point somewhat. We will therefore consult him on the subject. and the chief of these conclusions is. On Alopecia Areata and its Relation to Ringworm. April 1893). Baryta carbonic a. 177 ringworm. that "all well characterised cases of alopecia areata are in direct connection either with ringworm or pityriasis versicolor. and Natrttm muriaticum. Mr Jonathan Hutchinson brings forward a series of cases {Archives of Surgery. He says he does not think that anyone will read attentively the items of evidence (i. and that they . of alopecia. and seeks to connect them serologically with the Skin. and Arsenic. acid. late President of the Royal College of Surgeons. Fluoric acid. Goullon (the second) praises Graphites. Probably few people know more about this subject than Mr Jonathan Hutchinson.e. Mercttrius.

here on the other hand.have little or nothing to do with the state of the patient's general health. and which are attended by the development of others in their vicinity. and I much doubt whether there is any class of cases in which the shedding of the hair becomes universal which are not of the nature of alopecia areata." and refers to a paper read at the International Medical Congress in the Skin." Our author reckons hereto all cases of loss of hair beginning as smooth bald patches which are abruptly margined." Alder Smith (" Ringworm : its Diagnosis and Treatment. 1885) says alopecia areata "is due to a state of perverted nutrition and not to any vegetable parasite. alopecia areata is declared to be //072-para- . ijg 1 88 1. which tend to spread at their edges. on the Cause of Alopecia. whilst in others the patch may remain single and solitary for a year or more." 44 Differences in the rate and extent of progress do not seem to me to imply any difference in the essential nature of the disease . having never been able to discover any fungus in the club-shaped stumps. proving its non-parasitic nature. by Dr Liveing." So. " It is hardly necessary for me to remark that I fully agree with this view. N 178 Diseases of " In some cases the patient may lose every hair on the body in the course of a few months. Alder Smith adds." London.

denied by the patient. Mr Hutchinson's concluding remarks on the relation of Alopecia Areata to Ringworm : — " Concluding Remarks. who had suffered at the same time from ringworm. and Mr 180 Diseases of Hutchinson thinks this is due to the infection coming from cushions and the backs of chairs. In several instances the history of the original attack of ringworm was. Alder Smith declares "there is no fear of the disease soreadinor . by any means. with some of his views. in the first instance. Bringing ringworm and alopecia areata under one head is so important. and therefore children with alopecia may be allowed to attend school without any risk to others. "It will be cases which are many in quite clear seen that amongst the I have related there which the evidence was that ringworm had pre- the Skin. 181 ceded the alopecia. that I will give Mr Hutchinson's own concluding remarks. His final remarks are rather long. premising merely that I do not agree.sitic ." The bald patches of alopecia areata commence most commonly at the back of the head. having been . and with regard to allowing a child with alopecia into a school. There are several in which two members of the same family. became subsequently the subjects of alopecia. but demand earnest attention. There are also some in which no proof of such connection could be produced.

for I have found that almost invariably the first answer to the question.either not known or forgotten. but was subsequently supplied. Much patience is indeed necessary on this point. These cases. if they can. some doubted the diagnosis . others . Some patients have quite forgotten it . with much better hope of success. differ only from those of other observers in that. to ignore the fact. I suspect. The cases are a fair specimen of my personal experience during the last few years in reference to the disease in question. no history of antecedent ringworm is forthcoming. being specially interested in the point. do not shake my belief in the creed that alopecia areata is a disease in connection with cryptogamic growth. and their results will. and one and all are very willing. I freely admit that in a very considerable number of cases. and can usually inquire at home as to what happened in their the Skin. some never knew what the disease was . even after painstaking inquiry. Inquiries on this head must be expected to give negative results in hospital practice far more frequently than amongst private patients. ' Have you ever had ringworm when a child ? ' is in a strong negative. I suspect that some of them are examples of direct contagion from alopecia itself. however. iS o youth. I have 1 8 2 Diseases of been more patient than usual in seeking for the history of ringworm. The latter are more intelligent as to their antecedents.

Concerning the latter malady. Alopecia areata is. and.of contagion to the heads of adults from ringworm in children . lastly. I cannot escape the conviction that they all do so. although alopecia but rarely exhibits contagious properties. I admit that this cryptogam has not yet been satisfactorily identified by the microscope. and of such remarkable sameness in its clinical history in different cases. I have no doubt that it is transmutable with ringworm. 1 8 5 of them depend on antecedent ringworm or upon direct contagion. others of contagion from pityriasis versicolor. Thus. and that in the majority of cases the most careful examination will fail to give any indication of its presence. that it is extremely difficult to entertain the belief that it depends on one cause in one case. and upon a totally different one in another. I cannot but think that its cases ought all to be placed in one group. " There are certain other facts which favour the belief just expressed. a disease of such definite features. and since the evidence is so strong that some the Skin. it sometimes does so. and does not grow in the hairs themselves. My theory respecting alopecia is that it is due to some form of 184 Diseases of cryptogamic life. and more than one series of facts are on record in which it prevailed as a household epidemic* * "By far the best example of epidemic alopecia with which I am acquainted was . which develops deeply in the hair follicle. however. Many authors have recorded instances in which it affected several members of the same family.

C. the second in March. and both failed. as in alopecia. Dr Bowen and Dr J. The hair-bulbs were wasted. saw the cases. We may. however. entertain absolute incredulity as to what is called the neurotic form of this any particular remedy. No preceding stage in the least resembling ringworm had been observed in any of the cases. May 1892. I think. and it was not thought that the cure was due to the use of the Skin.recorded in the Bosto?i Medical a?id Surgical Journal. to detect the presence of any cryptogam. it appears to prove beyond dispute that there may occur a form of alopecia in patches which is actively contagious. and between the latter date and June i st the total of sixty-one had been completed. and distinguished dermatologists. " Whatever opinion we may incline to entertain as to the name which we should apply to the disease in this very remarkable outbreak. and yet is unattended by any fungus which the most modern methods of research can demonstrate. I am indebted to Dr Richmond Leigh for a detailed abstract of 1 86 Diseases of 11 The entire absence of any form of ill-health in the subjects of alopecia areata induces me to put this important paper. The matron and four older girls who acted as her assistants escaped. White. Most of the cases were getting well in the course of a few months. both of Boston. and both agreed that their general features were indistinguishable from those of alopecia areata. On this point. there is much room for fallacy. 187 wholly aside any inquiry on that score. and no fewer than sixty-one out of sixty-nine suffered The first case occurred in January. The bald patches are stated to have been smaller and more numerous. on microscopic examination. . It occurred in an orphan asylum for girls.

" Lastly. or indeed usual. but which may by a sort of accident become so. such as those described in Archives. 189 lateral asymmetry. in the majority of those who consult us. I allude to epidemics of pemphigoid porrigo. Such influences may be found. are also. not usually virulently contagious. It attacks young people more frequently than others. mental worry. and of any definite uni- the Skin. the frequent. etc.The narrative may be placed side by side with those respecting certain other maladies. iii. if sought for. and to those of epidemic eczema in workhouses. p. " The mode in which alopecia develops. to those of puerperal fever. which have recently claimed much notice in my pages. 206. We know of no neurotic malady which has round patches that spread at their edges. and they are usually those in whom neither headache nor any species of neurotic disturbance had been observed. the rounded form of its patches. and the like. are all in favour of the . vol.. creosote. conclusive evidence as to its not being of neurotic origin. as related by the late Mr Storrs of Doncaster. blistering. absence of bilateral symmetry. and their tendency to enlarge serpiginously." 1 88 Diseases of disease. I may allege that the modes of cure in alopecia areata by chrysophanic acid. I think. and I feel very certain that when they chance to be coincident with alopecia they do not stand to it in the relation of cause. It does not appear to me to be worth while in such a malady to ask an adult patient as to overwork.

"4/^. when it becomes general. They are not susceptible of satisfactory explanation on any theory that I am acquainted with. ' ' Summary. with the presence of a togam. after an interval. at some former period. are of one and the Skin. A few cases occur to those . its falling off again. by abruptly rounded and quite smooth patches. " 2nd. probably the majority. spreads by the development of other patches from the parent as a centre. themselves suffered from ringworm. Many cases. It is probable that all the cases which are well characterised. are very curious. occur in patients who have. remote direct. and. It is probable that all of well-characterised alopecia are in some connection. The facts as regards the 190 Diseases of occasional re-growth of hair. favour the belief in its cryptogamic nature.belief that it is a disease of local origin. but they fit more nearly with some facts that have been established as regards cryptogamic life than with any other hypothesis. " I may venture to offer the following conclusions as a summary of my present belief in reference to alopecia areata : — " 1st. and. 191 the same nature as regards causation (possibly there is some slight exception to this in reference to syphilis). cases areata or cryp- " 3rd. So also the facts that it always begins as a single patch.

193 29. and hence the young lady was brought to me. There are a few cases in which ringworm assumes. 192 Diseases of " $tk. from the first. shiny. the features of alopecia areata. This young lady's father's sister . and Bacill. and the discharge would at times dry up into scabs. the remedies being Med.. Her father was formerly cured by me of eczema . suffering from a skin affection showing itself as eczema of the outer ear and meatus. the explanation of the frequency with which alopecia areata begins on the back of the head is probably that it is caught by contagion from the backs of chairs and cushions. was brought to me on September the Skin. She was cured in about six months. " 6th. These may occur both in children and adults. 1 89 1. In a few cases it is possible that pityriasis versicolor on the chest of an adult may be the cause of alopecia areata on the scalp. Some cases occur to adults as the direct result of ringworm-contagion from children. 1000 and CC. Miss Ethel S. been exposed to its contagion. at some former period. She has very large tonsils ." Eczema of External Ear and Meatus. her throat is swelled and irritable. but who have.who have never shown signs of ringworm. Lastly. 14 years of age. etc. the surface of which was wetting. 1000. and in the early morning she feels sick. and in part scaly. " ytk.

lest the relatively fair the Skin. and it is this : Fifteen years ago I was treating a wee child of another branch of this family also for eczema that extended to the greater part of the poor mite's whole body. and the services of an eminent dermatologist were secured. Hence I gave my opinion that it would be dangerous to use local applications to the skin. Things went on very smoothly for a very few weeks. o 194 Diseases of There is a tragic circumstance connected with my professional relationship with this socially important family.has also been cured by me of eczema. to which conclusion I came from finding such hypertrophied or indurated glands in parts where there was no active eczema. What I am trying to say just amounts to this : My treatment was given up in contempt because I would not give any ointment or wash whatever. and her brother is now under my care for very severe eczema. and not merely from cutaneous irritation. but the patient not long afterwards . I explained to the parents that I regarded the eczema in question as of a very pronouncedly constitutional nature. and that it was this constitutional disease that caused the truly terrible eczematous ooze. the skin being merely the medium of relief of the organism. and primarily so. 195 general state of the patient should be impaired : nearly all the glands were enlarged.

— The improvement is very great indeed. and worse in the evening. She has strumous scars in her neck. The pains are described as worst when she starts off. feet better . did her a little good. 1890. came to consult me on October 16. which. 1890. 56 years of age. November 25. moreover. she sleeps so much better.— in fact. she thinks. feet. and. — Patient hurries to . for pretty severe rheumatoid arthritis of three years' standing. December 5. and worse on the East Coast than in London. for all the pain has gone and the swelling has sensibly diminished . Bacillhmm C. quite startling. shallow work ! Acute Universal Erythema and Chronic Rheumatoid Arthritis. elbows. Patient had been vaccinated three times. A maiden lady. To continue the same medicine. the Skin. Although fifty-six years of age her menses are regular. can stand better . was given for a month. She has just returnedfrom Buxton. 197 so that they are not of much use to her. and knees. affecting hands. Her hands are swelled a good deal.died "of weakness and exhaustion. but oh ! the shallow." In my judgment she died of the 196 Diseases of practical application of the dermatologist's gross ignorance of dermatology : bedaubing and besmearing the skin with medicinal substances was the work of this probably wellmeaning medical man .

in fact. the rheumatism had gone.. and we know well what the great Erasmus's " cures " were. She describes the irritation as terrible in the heat .. Cases that stand. rather papular. but patient only came two or three times . the last time I saw him.. Rhinophyma. C. both he and I were satisfied that the nose was somewhat smaller. fy Thuja Occident alis 30. and the case that seemed perfectly cured is not quite cured really. The lady's sister tells me that the late Sir Erasmus Wilson once cured the lady of eczema. 30. February 19.. and . I did not quite succeed. — With very great difficulty I prevented this lady from putting something on "to cure" the erythema . Genuine severe rhinophyma is not a common disease. the Skin. The point of greatest interest to me in this narration is the vicarious erythema. 199 I saw a middle-aged lady yesterday whose hands are swelled and much disfigured by rheumatoid arthritis.. and a month later Bacill. which is covered all over 198 Diseases of with acute erythema. One case was under me last year. — The hands are not so well. midway between nasal dermatitis and rhinophyma are not . 1891. as the hands are stiff again and somewhat swelled. IjL Psor. January 1. so to speak. 1S91. finished the cure..me to show me the dreadful state of her skin.

all used in dynamic dose. Case of Eczema Glandis of Six Years' Duration.so rare . and no local application whatever.old little boy to me to be treated for eczema in the bends of the knees : these regions were pretty badly affected. Jttne 7. — Nearly well. I gave Syph. This finished the cure. but the eruption still the Skin. a lady brought her three -year. principally Thuja. 3ij. — Much better. and the little man's cervical glands were considerably enlarged. 32 years of age. 1887. On May 10th. and both with our common antisycotics. Patient was pucetm. three drops in water night and morning. August 1. CC.. . and Cupressiis. 201 itches in the warmth. As the eczema was most trying in the warmth of the bed. An unmarried rufous gentleman. He informed me that he had formerly had eczema on his head. 1888. came under my observation on May 18. Acidum uricttm 6. Eczema in a Child of Three. for left-sided varicocele and eczema of the glans and of the sulcus of the penis . I cured two such cases in 200 Diseases of 1 89 1. Aciditm hippuricum. notably of the glands. Sabina. the eruption had been there for six years. in very infrequent doses for a month. the same as the previous prescription.

At the end of the year patient said there was a very little of the eczema still in the sulcus. worn. and then upon Bellis perennis for a month. 202 Diseases of five drops in water twice a day. This cured the eczema. 30 years of age. 1 89 1. so to speak. Case of Eczema.I first gave him Clematis ei'ecta \ x . her general state so debilitated. and being specially bad in the bends of arms and on the face. and weary. 203 eight months. I do not want the doctor. for about the same length of time. even to please her husband. with very great amelioration . most distressing of an evening. so I put her on Levico for a few weeks. Her lips are dry. her appearance so old. that I felt it to be imperative to better her blood life and pull her together. he had from me Melitagrinum C. for about five weeks he was under Malandrinum 30. and worst of all around the mouth ." 204 Diseases of . " Oh ! I'm getting on nicely now . A married lady. remarking. andpatient ceased attending. and thereafter. " for ever peeling. but he did not think it worth while being treated for it." Patient's condition was so bad. was brought to me by her husband on December 4. cracked. when patient would not come any more. with pretty severe eczema that had been bad during the past the Skin. but with no benefit. before setting about a scientific cure of the case. mother of two children. In June and July.

" He is much afraid of the powders. worse in the morning . — The skin is cleaning. only the pustules are those of acne. A powerful. and Asthma. 58 years of age. which he got cured with ointments . there is no matter in it now. fy B acilL 1000. His appearance on being undressed was as if he had small-pox of moderate severity. this he keeps down w T ith Turkish baths. August 26. telling me a history of slight winter asthma for many years . and got this also the Skin." October 2. the skin is rather better . Eczema. somewhat asthmatic gentleman. September 8. (CC. which he has taken regularly ever since he was 21 years of age. . — Much better.Case of Ringworm. 205 cured with ointments . came from the north to consult me on the 1 2th August 1891. and then came this pustular eruption which ointments will not cure. Acne. — "Those powders are too much for me . He tells me he had "three ringworms across the belly " in the month of February 1881. they cause me bad breathing and sickly feeling . $ Rep. — Much better. "they act so powerfully. Rep.) October 16. and then he got eczema.

It was all over his body. 1890. Very Severe Case of Sycosis. 12.R Rep. but ceased to do so after this rash came out. Now he has neither skin disease nor rheumatism. " I am so much better in myself. 20. and still continues well. . the breathing being now normal. years. — infinitely better in every way. for an eruption of the skin. and had been there for the Skin. On September 26. Urtica urens 6. The same remedy was repeated a few times. 1890. 41 years of age. (C. and Sodium salicylate. that I can only call brawny dermatitis. This gentleman was discharged cured in less than a year. and Thuja 30 was interpolated.) October 30. and went abroad to divert his mind from grief due to the death of his wife. a London professional man. and itched a great deal. Patient formerly suffered from chronic rheumatism. when patient was well. The remedies I used were Persicaria urens 30 and 3." Brawny Dermatitis. The last time I saw him his exclamation was. An elderly gentleman consulted me on Nov. — The chronic diffi- 2o6 Diseases of culty of breathing (the asthma) has gone.

but I am in despair . and his gums and mouth generally he describes as "rotten. I have had this beastly skin disease for twelve years (pointing to his chin and face). Said he : 2o8 Diseases of " I have always ridiculed homoeopathy. was a " mass of corruption. 209 keeps it down pretty well in the summer months. or stand out from the gums ready to fall out . An ointment he uses the Skin. — of course all allopaths. and do not believe in it the least little bit. He has also very severe pyorrhoea areolaris ." Patient's chin and face. dried up. which he was obliged to get off very frequently with the aid of a poultice. but is powerless from autumn to spring.married.e. and in fair general health.. and been very severely handled by the skin specialists. and •the bulk of his very beautifully formed teeth have already fallen out entire. co-extensive with his beard." — i. caked together mattery ooze. and I have been under treatment all the time by the most eminent surgeons of London . Patient has been twice . altogether I have been under eleven different doctors. and on the earnest solicitation of a friend and neighbour. came to me as a dernier ressort." He has had recurrent ophthalmia many times. having undergone scarifications and epilations at many different times. when the surface was red and angry and shiny. his breath is stercoraceous. his gums have receded. He tells me he has used scores of ointments. the sticky stuff at once beginning to appear again.

2io Diseases of My treatment was continued till June 10. . under the influence of very high dilutions. Note on Levico. and Calc. when I was able to declare him. Jeqtiirity 3* Levico 6 (the strong water).vaccinated. here progress seems suspended. appears to get excited and into a state of unrest . sulph. In very difficult and pathologically complicated cases the organism. — Continues quite well. figuratively speaking. The waters of Levico are a very favourite remedy of mine in many skin affections where I need a little tonic. and one then needs. Practically patient had all the leading nosodic and other antisycotics. well* Treatmentextending overall these months necessarily comprises a number of remedies. A capital way to administer it is to order ten drops in a wineglassful of warm water two or three times a day. and where it seems of great advantage to give the organism a rest from the effects of high dilu* July 1893. a harmless material — something to clean the slate and so get a fresh start : this the strong water of Levico does beautifully. as he declared himself. the Skin. by preference immediately after meals. as well as Zincum acet. 2 1 1 tions of the more specifically acting remedies. 1. 1892. majus 0. Chelidon. The feeling in the diseased part he describes as stinging. the case being so severe and of such long standing.

for this mite of a boy was already an inveterate masturbator.. 6 Nat. Perspiration less offensive. mur. — Quite free from the Skin.m. Six grains three times a day.Offensive Perspirations. Augtist 9. fy Nat. very bad at 7 p. An unmarried lady. came under my care on July ii. and the perspiration has ceased to be offensive. of which patient had long been free ! Thereupon she immediately took quinine. 1892. The headache was really brow-ague at a spot over the right eye. — The powders brought back the ague. 2\ years of age. September 12. oniony \ nettly. or . Lichen Urticarius. Tjt Trit. 38 years 212 Diseases of of age. mur. 30. 213 headaches. was brought by his mother to me on the 7th of August 1890 for lichen urticarius. A bonny boy. principally for headaches and offensive perspirations. The perspirations were described as sour. The cure had held good when I last saw patient in February 1893. where she had ague badly.— Periodical Headaches. The urticarious spots were usually at their worst when he got warm in bed. Patient had lived some years in India. But there was an even more distressing feature in this case. and recurring every eleven days.

hot at any time. He had seatworms, picking his nose a good deal.
He was about a year under my
treatment, and was then discharged
quite cured, not only of his cutaneous

214 Diseases of
affection, but also of his nose-picking
and of his secret habit of mauling
himself about ; for it was noteworthy
that while he would pick his nose
freely enough before folks, and even
notwithstanding their forbidding it,
he did not masturbate other than in
secret.
The remedy that cured the skin
affection was very evidently Bacillinum C. during one month at the
beginning of the cure, and the
sairie remedy in the two-hundredth
dilution later on. The remedy that
cured his secret habit was very
clearly Platina 30, under which he
was during three separate (not. consecutive) months. There were intercurrent ailings — cough, cold, anorexia — and Thuja 30, Ipec. r,

the Skin. 2 1 5

Ledum $*> an d Med. CC. respectively came into play. The precise
parts played by these other four
remedies in this case I could not
quite determine. More particularly,
I do not know which cured the seatworms. But, as before stated, I am
very sure the lichen was cured by
the Bacill, and the masturbation
was cured by the P latino, 30.
[On the subject of Platina in this
regard, see Grauvogl's LekrbuckJ]
Remarks on the Origin of SelfAbuse in Children.
The case of lichen urticarius just
related teaches a lesson which

physicians and parents might with
advantage remember. We are far

216 Diseases of
too apt to suppose that vice and
vicious habits are due to abstract sin
trickling down upon us from the dim
and distant past, or as simply generated, as it were, afresh by innate
sinfulness. Well, in this we err
egregiously. The best way to get
at the core of a nebulous subject is
to take concrete cases separately,
from the very simplest standpoint.
So let us take this simple case of
nettle-rash. What was the nature of
the lichen ? Was it morally sinful ?
Clearly it was simply physical
disease, and in this case probably
from the boy's father. Was the
nose-picking a sinful habit ? or due
to physical disease ? By common
consent nose-picking indicates gastric irritation, and most frequently

the Skin. 2 1 7

worms get the blame. This boy
had worms.
We do not reckon his lichen or
his worms unto him as sin, but
recognise their simple morbid
basis, and use remedies to cure
them.
So I do with masturbation generally ; so I did with this boy's secret
habit, that, left uncured, would most
probably have resulted in his becoming both physically and morally
a wTeck. But not only was the
secret habit in this child completely
cured, but he, in the words of his
mother, " does not like to do so," —
i.e., his sweeter [healthy) moral self
shrinks from the very idea.
Have the schools any therapeusis
to compare to this ? I suppose a

2i8 Diseases of
soothing lotion or ointment for the
child's moral nature.
Eczema of Ears of Seven Years'
Standing.
On August 20, 1887, a little girl
of nine was brought to me for an
ill-smelling discharge from the ears,
that was said to have started after
she had had dysentery seven years
previously. In the fold of the left
arm a little eczema. Although only
nine years old the child had been
twice vaccinated, and was clearly
quite blighted thereby.
After being under treatment by
Thtija occidentalis 30 for a month,
my note runs, "Vast improvement
all round."
After a few weeks respectively of

the Skin. 2 1 9

Sabina 30 and Sulphur 30, patient
left cured at the end of the year 1887.
Flat Papilloma in the Anal
Region.
A childless married lady, a little
over 30 years of age, came under my
observation on July 19, 1887, for
certain very distressing symptoms
in the anal region, preventing sleep
at night : worst at 2 a.m. On
examining the parts I found the
anal opening surrounded by haemorrhoidal buttons, and on the tip of
one of these a flat papilloma about
the size of a split horse-bean. By
day the whole region was exceedingly uncomfortable only, but by
night its soreness prevented sleep.
^ Syp. CC.

220 Diseases of
Atigust 1 6. — Very much better
indeed ; sleeps now quite well.
An examination shows that the
papilloma has quite disappeared.
Patient remained another couple
of months under my treatment for
the haemorrhoids. These quite disappeared during that period under
the influence of, first, Spiritus
glandium quercus 0, and then of
Euphorbia amygdaloides.
Pruritus Ani.
A general staff officer, no longer
young, came under my care on
Dec. ii, 1 89 1, complaining bitterly
of being roused up at night with
fearful itching at the anus. An
examination of the part showed
only the very slightest degree of

the Skin. 2 2 1

eczema. Being of opinion that the
pruritus was due to port wine, I
ordered Spiritns glandhtm quercus,
ten drops in water night and
morning. This cured the pruritus.
When I next saw the general he
said, " That's all right ; now I want
something for my bronchitis."
The complaint was chronic winter
catarrh of the bronchial lining.
The Acetum Lobelia, in four-drop
doses every four hours, quite cured
this in about three weeks.
Case of Bat's Wing Disease —
Lupus.
A maiden lady, 48 years of age,
from Shropshire, came on August
5th, 1892, to consult me for an eruption on her nose and two cheeks,

very slowly worse for the past twelve years. and this again dries and in its turn peels off. and her other six brothers all died in infancy. September 2. Patient's father is stated to have died of decline at 57 years of age. except in the right side near the eye. H er three sisters are alive. and the whole of the skin is not involved. — The bat's wing is half gone ! ^ Rep. principally Arsenic and Mercury. 4. where it is more active. Nov. and her mother. 30. One of patient's brothers died of phthisis. died at 52 of mesenteric atrophy. — Nose quite free. patient tells me. leaving the underlying skin red. — Patient writes me under this date from her home : "I have no trace of the disease left. The skin peels off in little flakes. but . Sept. 223 ^ BacilL CC. The eruption is getting very. but very. there being healthy skin between.222 Diseases of the figure thus produced being responsible for the designation of bat's-wing disease. A good deal of haemorrhage from the rectum. very slowly. £ BacilL CC December 9. Patient informs me that she has been three times vaccinated. 1^ Thuja 30. the Skin. Patient has had active treatment. near the corner of the eye. — There is just one small spot of the eruption left.

is better in the evening. barring an enlarged spleen and little spells of nose-bleed. The patient had had measles. was brought to me by her elder sister on Dec. and had also been twice vaccinated. and itched a good deal on going to bed. Her spleen is enlarged . stomach. Papular Rash. 1893. Her menses were the Skin. January 13. in answer to my inquiry. informed me that patient continued perfectly well. An unmarried lady. 15." R Rep. and jaundice during the course of her little life. worse in the morning. 23 years of age." And four months later the lady's sister. chicken-pox. for a very disagreeable rash on the body. 1^ Thuja occidentalis 30 in infrequent doses. anaemic. In two months patient had gained five pounds in weight and was quite well.the piles have bled on four occa- 224 Diseases of sions. I was so well while taking the powders. and complains pretty eloquently of flatulent dyspepsia. This was cured in a few weeks by . The eruption occupied the skin over the chest. and duodenum. 225 -irregular . she suffered from nosebleed. she twitches and jumps (starts) a good deal . " I eat double. — The skin remains quite well. Patient is very costive. 1890. whooping-cough.

See my little treatise "On Vaccinosis. and the young lady has Q 226 Diseases of continued to thrive ever since. of . and so sent the . ten drops in water at bedtime. a piece of gum paper was put over the place. The only epidemic of eczema. and gave some ointment to be applied when ' the wound ' was cleaned. At the end of two days I felt sure the diagnosis had been wrong. so her mother told me quite lately. " A few days served to show that the thing was more than a simple bruise." Epidemic Eczema. and as the years roll round I become more and more certain of my thesis. I have often maintained the reality of vaccinosis as a morbid entity. " Dear Sir. within my experience was one that broke out in the spring of 1891 at a very large public school near London. ordered on a bread poultice.Urtica urens 0. Thinking it merely a bruise received the previous day whilst playing football. 1891. apparently contagious. — On or about the 5th of this month a spot appeared over the eyebrow of the bearer (my the Skin. The news came to me thus : — "March 16. he also thought it merely an unhealthy wound. 227 son). so we sent him over to Dr .

" There were quite a number of cases besides these. "This morning the thing has assumed such alarming proportions that my husband and I felt we must have your advice regarding it. The eruption itched very much in the evening. „ of face and nose. and six-grain doses frequently repeated. Abuse. The iodide of sulphur in the third trituration. " Three of the boys playing in his team have broken out with the same kind of eruption. chronic crops of. 174. 228 Diseases of the Skin. 204. flat papilloma in the. were prescribed.boy over again to the doctor. INDEX. 99. It was then pronounced to be eczema. and there has not been any return of it. 54. Anal region. 219. „ ringworm. 215. fruit. 176. its relation to ringworm. in children. and had spread a good deal when the lad called upon me with the just-cited letter of his mother. 128. "Rims tox. self. and a fish. and vegetable diet insisted upon. Ague — scabies. 164. 40. patient's brother being one of them. „ and swelled neck. and zinc ointment externally. Alopecia areata. and eczema. and nasal dermatitis. „ from cold drinks. inwardly. Acne and boils. cured the eczema in both lads in about six weeks. Angina pectoris from suppressed skin dis- .

. Begbie. curative of complaints due to cold drinks when the body is heated. „ specific enexanthematic. in acne and swelled neck. Barium of very distinct advantage in ichthyosis. 150. 52. on tetters. 230 Index. Arthritis. 220. Dr. Ani. soft warts round the. 89. Anglo-French School on lupus. 73. and enlarged liver. 78. on the connection between lupus and tuberculosis. M. Bacillinum C. 100. on cases of skin diseases. Betula alba. Bernard. 104.. 2 3 1 Boils and acne. on epidemic alopecia. of Boston. 20. 5°Besnier. Dr J. psoriasis. . chronic crops of. 5. Bazaroff. Bowen. Bellis perennis against the ill-effects of wet cold in the overheated. trachoma. and erysipelas. on suppressed perspiration of feet. 1. report by. Index. on lupus. 142. and acute universal erythema. 196.ease. Dr Porfiry G. Anus. 129. 164. Warburton. „ CC. on psoriasis. 159. 221. Bat's wing disease — lupus. Dr. 51 . pruritus. Dr. 120. 7. chronic rheumatoid. Becker. Asthma. 120. cures strumous eczema in a baby. Arthritic urticaria.

99.. Curability of. 204." 48. Ears. . Dublin Journal of Medical Science. Chin and throat affections. on " Curability of Cataract with Medicines. „ hairless patches on. acne. 145. 48. Dermatitis." 31. on "Vaccinosis and its Cure by Thuja. and ringworm. Children. dysentery. 192. acne from. external. „ — ringworm of scalp. Burnett. „ . Eczema. 72. its use in haemorrhage. and against the ill-effects of wet cold in the overheated. 206. 123. „ acute — dyspepsia — vomiting — neur- . „ habitual periodical facial. brawny. 11. nasal. C. Dr J. 40. „ — scabies — furuncles. Crusta lactea. self. „ vaccinal.. 206. ■ — eruption on scalp. 50. Cold drinks.. Ear. C Burnett. 232 Index. by Dr J. of seven years' standing. 37. with Remarks on Homoeoprophylaxis. 104. . Daisy. life-long. with Medicines. eczema of. 10 1. „ double.186. 218.abuse in. Brawny dermatitis. Dyspepsia — vomiting — neuralgia — neurasthenia — acute eczema. 46. 215. 61. Cataract. Constipation. 30. 49. the. 27. eczema of. from suppressed eruption.

104. " Etiology. acute universal. 52. and trachoma. „ suppressed. on lupus. Goullon. diseased. hydrocephalus. 153. 192. pustular. „ in a child of three years old. with internal metastatic symptoms. Erysipelas. Dr Tilbury. „ of external ear and meatus. . 14. 202. suppressed perspiration of.algia — neurasthenia. . Favus. 155. ophthalmia. Index." Fletcher's. 233 Eczema. „ glandis of six years' duration. 160. 8. 12. . 234 Index. gouty. 145. Ewald on lupus. ^^. Dr. case of generalized.. 24. ossified heart from. „ severe case of sixteen years' standing — elephantiasis labiorum vulvae — life-long constipation. 150. 48. Furuncles — scabies — cataract. 100. 200. 123. 69." 98. „ inveterate. — enlarged ovary — chronic oophoritis. „ strumous. Headaches. „ epidemic. &6. 218. Fletcher's " Etiology. Fletcher. „ capitis suppressed — fatal issue. 155. periodical — offensive perspira- . 98. 201. of Weimar. . latent vaccinosis... 49. acne from cold drinks. 20. habitual periodical. „ of ears of seven years' standing. „ nasal. and chronic rheumatoid arthritis. psoriasis. Erythema. 196. in a baby. in married lady. Fox. 31. 78. 10. Enexan thematic asthma. 92. Feet. 43. Eruption. case of. 226. Gouty eczema. Facial dermatitis. 5. Finger-nails..

Dr James. Kundrat. Liver. . 117. 92. report of case of generalized favus. eczema. 176. on epidemic alopecia. case of. 211. Homceoprophylaxis. 78. Heath. latent vaccinosis. Hydrocephalus.. 73. 7. clinical aspects of.. Jonathan. on lupus. 167.. 73. 92. . 138. 157. .tions. on lupus. 80. Hutchinson. and psoriasis. his autopsy of case of generalized favus. Ichthyosis. by Dr Burnett. Kaposi on generalized favus. 179. 76. 93. . Leigh. ossified. asthma. 175. Heart. enlarged. Herpes s. from suppressed eczema. 77. on lupus. London Medical Record. Hughes on alopecia areata. on alopecia areata. Dr Richmond. 221. 74. Professor. 14. note on. 235 Hyde on lupus. 185. Liveing. Dr Robert. 8. on lupus. on the cause of alopecia. Index.. Levico. 82. Koch. his preparation of erythrinus. Dr. tinea tonsurans. remarks on. Lichen urticarius. Houghton. . „ urticatus. 210. Lupus — bat's wing disease. 213. 31. Dr Alfred.

. chronic — eczema — enlarged ovary. 37. Index. flat. 69. 237 Papilloma. swelled. „ (tuberculoderma). Neuralgia — neurasthenia — acute eczema — dyspepsia — vomiting. 14. Neisser on lupus. 87. internal. Patches. Patch. 71. his inoculations from conjunctival lupus. 224. Oophoritis. 219. 128. Metastatic symptoms. . Lupus. Nasal dermatitis. Miliary tuberculosis. 86. 160. Papular rash. Ovary. 76. „ erythema. on chin. 69. 40. eczema. 87. 236 Index. 83. the sternal. 24. experimental. in his Kriegs-Artzeney. . Perspirations. hairless. commends the daisy. in the anal region. histological. Ossified heart from suppressed eczema. 211. 102. and acne.„ constitutional nature of. 12. Neck. 79. offensive — periodical headaches. 56. Pagenstecher. in eczema. &$. Ophthalmia. enlarged — eczema — chronic oophoritis. 145. Mindererus.

33. 31. London Medical. disappearance of. „ (herpes s. after erysipelas. 103. 46. D. 103. 199. in his Medicina peregrinantium. 11 Ringworm : its Constitutional Nature and Cure. 168. Rash. Christoph. eczema. Ringworm. „ — cataract — furuncles. Schroeder's. on disappearance of psoriasis and trachoma after erysipelas. 224. Scabies — ague. . 238 Index. „ asthma. 7. 167. „ its relation to alopecia areata." commends the daisy. Sarcognomy. Rhinophyma. 49. 136. eruption on — cataract. tinea tonsurans). 204. Compton Burnett. 162. 54. Scalp. papular. chronic. Johann. Record. 46.. . and acne. Pruritus ani. Platanus of very distinct advantage in ichthyosis. 220. 196. 176. 20. Rheumatoid arthritis. Schorer. commends the daisy. 60. 100. life-long eruption of. Psoriasis and trachoma. 27. 120. and enlarged liver. " Pharmacopoeia Universalis. „ ringworm of — cataract. Pustular eruption. „ of scalp — cataract.Pityriasis rubra." by Dr J. 20.

Dr Walter G." by Dr J. 142. „ Prof. Sine ira et studio. Throat and chin affections. on alopecia areata. 8892. Thomson. Thuja as used by Dr Burnett for cure of vaccinosis. Index. to internal organs.. "Vaccinosis and its Cure by Thuja. 87. 51. 178. on lupus. 129. absurdity of. remarks on the origin of. 30. 56. with Remarks on Homoeoprophylaxis. Specialism. Alder. 115. arthritic. Trachoma and psoriasis. 72. 66. Tetters. 20. 239 Smith. Sycosis. ulcerating. 150. 63. the. 215. very severe case of. 94. 61. Vaccinal dermatitis. Tuberculosis of the skin. Sternal patch. 87. 207. his treatment of lupus. 90. Skin affections. Urticaria. C. Tuberculoderma (lupus). Dr Todd. Tumours and the skin. 87.Scrofuloderma. Self-abuse in children. 31. „ • tuberculosis of the. after erysipelas. 3 1 - . „ in acne and swelled neck. as treated by Dr Becker. Burnett. Strumous eczema in a baby. 240 Index. relationship of. 87. disappearance of.

70. latent. 199. C. • Vienna School on lupus. ulcerative eruption of. PRINTED BY OLIVER AND BOYD. Vomiting — neuralgia — neurasthenia — acute eczema — dyspepsia. EDINBURGH. his treatment of eczema.r on lupus. 84. 75. 159. Erasmus. 74. Veiel on lupus. 145. on epidemic alopecia. 131.. Vidal and Leloir on lupus. „ Erasmus. Vulva. 3. Ziegle. Wilson. Dr J. 75. of Boston. White.. his treatment of suppressed skin disease. hydrocephalus. crop of soft. 8. 186. 79. Warts. eczema. Date Due " — — . round the anus.

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