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Selected Monographs on Dermatology

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Selected Monographs on Dermatology >V!U'. fyxmll IMwmtg plrmg BOUGHT WITH THE INCOME PROM THE SAGE ENDOWMENT FUND THE GIFT OF 3*em*g mt Sage 1891 A4S±QJiM */M/&d. Cornell University Library RL 75.N53 er, t l °9y- Selected monographs on <] "*] 7l 3 1924 012 173 229 a Cornell University J Library The original of this book is in the Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924012173229 THE NEW SYDENHAM SOCIETY. INSTITUTED MDCCCLVI11. VOLUME CXLIII. SELECTED MONOGRAPHS ON DERMATOLOGY. TJNNA. NIELSEN. DTJHBLNG. BBONSON. BLANC. BEBGEB. PBINCE-MOBBOW. LONDON: THE NEW SYDENHAM SOCIETY. 1893. c*^ PBINTED BY ADLAED AND SON, BABTHOLOMEW CIOSE, E.C., AND 20, JTANOVEB SQUARE, W. CONTENTS. Selections from the Dermatological Writings of Dr. P. G-. Unna. [Translations, chiefly in Abstract. Edited by Phineas S. Abraham, M.A., M.D., B.Sc, F.K.C.S.I.] ...... 1 On the Appearance of Herpes Zoster during the Administration of Arsenic. By Ltjdwig Nielsen, M.D. .167 A Collection of Dr. Duhring's Papers on Dermatitis Herpetiformis . .177 The Sensation of Itching. By Edward Bennet Bronson, M.D. .299 Beport of a Case of the Mycosis Fongoide of Alibert. By Henry Wm, Blanc, M.D. With Lithograph . 317 Pellagra. By Ludwig Berger, M.A. [Translated and Abridged by Frank H. Barendt, M.D.Lond., F.RC.S.Eng.] . , . 341 Drug Eruptions. A Clinical Study of the Irritant Effects of Drugs upon the Skin. By Prince A. Morrow, A.M., M.D. [Edited by T. Colcott Fox, M.B.Lond., FRCP] With an Index . 355 Researches on Psoriasis. By Ludwig Nielsen, M.D. [Translated by Frank H. Barendt, M.D.] . .569 SELECTIONS PBOM THE DERMATOLOGICAL WRITINGS OP Dr. P. G. UNNA/ TRANSLATIONS, CHIEFLY IN ABSTRACT. EDITED BY PHINEAS S. ABRAHAM, M.A., M.D., B.Sc, F.R.C.S.I., LECTUEEE IN PHYSIOLOGY AND HISTOLOGY, WESTMINSTER. HOSPITAL MEDICAL SCHOOL; PHYSICIAN TO THE WESTERN SEIN HOSPITAL, LONDON; AND EDITOR OP THE ' JOURNAL OP THE LEPROSY INVESTIGATION COMMITTEE.' PREFACE. Dr. Uota's contributions to dermatological literature are so numerous that, with the space at disposal, translations or abstracts of only a few could be included in this volume. The editor, indeed, is quite aware that several important papers by the author will not be found in the series; and he wishes to state that, with one exception, the selection has been taken from a number of reprints which Dr. Unna him- self sent to the Secretary of the New Sydenham Society for the purposes of this work. A complete list, however, of the author's publications is appended. The translations are, for the most part, given in abstract. The Editor desires to record his thanks to Dr. Chichester May, and Messrs. H. Felkin and A. D. Abraham, who have materially helped him in preparing the translations and abstracts ; and to Dr. Alfred Eddowes, who is responsible for the article on Pavus. The proofs have been submitted to and kindly approved by Dr. Unna. P. S. A. LIST OF DR. UNNA'S PAPERS (TRANS- LATED m ABSTRACT). PAGE i. Lectures on the General Pathology of the Skin I 2. On Circular Patches of Exfoliation of the Palm and Tongue 46 3. On a Case of Cured Lepra Tuberosa 50 4. Syphilis and Eczema Seborrhoicum 54 5. Lichen Euber and its Treatment 59 6. Hyphogenic, Coccogenic, and Bacillogenic Sycosis 62 7. Three Varieties of Favus . 64 8. Becent Advances in the Therapeutics of the Skin 68 9. Contributions to our Knowledge of Lanolin . 9i 10. Medicated Superfatted Potash-soaps (Ointment Soaps) 95 1 1 On the Use of Ichthyol in Internal Diseases . 99 12. On the Treatment of Trichophyton Capitis 103 13. Advances in the Anatomy of the Skin 107 14. On the Normal Surface and Covering of the Tongue 119 15. On the Insensible Perspiration of the Skin . 122 16. On Skin Varnishes 125 17. The Action of Carbolic Acid and Oil of Cloves on Lupus 129 18. On the Cultivation of Epidermic Fungi 132 19. The Staining of Micro-organisms in the Horny Tissues 140 20. On Plasma-cells, especially in Lupus 145 Waldeyer's Plasma-cells 21. On and Ehrlich's Mast-cells 149 22. Some Observations on Rodent Ulcer 151 33. Contributions to Dermatology 152 LECTUKES ON THE GENERAL PATHOLOGY OE THE SKIN. DELIVERED IN THE WINTER SESSION, 1888-89.1 I. Anjemia. The vessels of the skin undergo greater changes of calibre within physiological limits than do those of any other organ, and this is due to the great development of its muscular and nervous apparatus. In its pathology, too, contraction of the vessels plays an important part, but here other factors are also at work in producing anaemia, viz. qualitative and quan- titative changes in the total amount of blood in circulation. If the anaemia be caused by contraction of vessels, the skin feels cooler and often less succulent ; but if the tone of the vessels remain normal, the temperature and the amount of fluid in it may be as before, although it may be anaemic. Hence anaemia of the skin may be divided into two great groups : (1) Anaemia due to general alterations in the total quantity of blood, and (2) Anaemia confined to the skin. Anaemia consequent on qualitative blood-changes may be due to a deficiency of red, or an increase of white, corpuscles, or to a combination of both factors. A want of red cor- puscles makes the skin and mucous membranes anaemic in true chlorosis, in acute and chronic inanition where the 1 " Vorlesungen liter allgemeine Pathologie der Haut, gehalten in Winter- semester," 1888-89—'Monatsh. fur prakt. Derm.,' ix Bd., 1889, Nos. 1, 2, 6, 8, and x Bd., 1890, Nos. 3, 4, 6, 7— I. Anamie. 1 — 2 tjnna's dermatological papers. patients cannot take food, in those recovering from con- suming febrile diseases, in pseudo-leukaemia, and in hydrsemia; but in leukaemia there is also an absolute and relative in- crease in the number of the white corpuscles, and in certain forms of anaemia and cachexia e.g. in absolute starvation and • advanced tuberculosis and cancer—in addition to a deficiency of haemoglobin, there is also a diminution in the total quan- tity of blood. Not only is there here a change of colour of the blood, but there is an adaptation of the vessels of the skin to the diminished supply, i. e. the stream-bed of the skin becomes contracted in simple diminution of the blood. This is seen, too, after loss of blood from wounds and opera- tions, and in cases of intestinal parasites, as in pernicious anaemia. After severe haemorrhage in young persons, the skin becomes waxy, yellow, and transparent, from the regu- lative contraction of all the vessels of the skin and absorption of tissue-fluids by the veins and lymphatics. The ashy-grey colour of the skin in cholera is similarly due to a general contraction of the cutaneous vessels, com- bined with increasing cyanosis of the blood, as the velocity of its current diminishes. The fall of temperature and in- crease of the vascular tone of the skin resulting from these quantitative anomalies of the blood, approximate such cases to the isolated anaemia, which we shall now consider, and in which qualitative changes are of course excluded. This anaemia may involve the whole skin or only parts of it. When the whole skin is anasmic, either the circulation in general or the central nervous system must be affected. Contraction of the cutaneous arteries always runs parallel with the anaemia, and sometimes this contraction follows a diminished blood supply ; but whether the arterial constric- tion or the diminution of blood in the skin be primary in any given case, is often as difficult to determine as in phy- siological experiments. Arterial constriction is certainly primary in the death agony, and it causes that unfortunate pallor which makes the post-mortem study of most dermatoses so difficult, and that of the circulation anomalies impossible. The paleness accompanying cardiac weakness, especially that which precedes fainting and obviates a dangerous fall of blood-pressure, is also probably primary in nature. To the GENERAL PATHOLOGY OF THE SKIN. 3 same category belongs the anaemia which accompanies or precedes nausea (ah injectio medicamentis, chloroform, swing- ing, and sea-sickness), and in which there is often an accom- panying inhibition of the splanchnics, causing plethora of the intestinal tract, the anaenria of the skin being here regulative. Reflex spasm of the cutaneous arteries is also often caused by the prodromata of an epileptic fit, by psychical disturbances (fear, sudden terror), and by strong stimulation of sensory nerves, especially of the abdomen, as in colic. The goose- skin due to mental perturbation indicates, moreover, powerful stimulation of all the unstriped cutaneous muscular tissue, including the vascular. A secondary adaptive contraction of the dermal vessels gives rise to the pallor following night-watching and exces- sive muscular or cerebral activity, when there is a collateral overfilling of the vessels of internal organs, according to their needs. The most important example of a general contraction of the cutaneous vessels is seen in the signs of all acute infec- tive diseases. Here the poison circulating in the blood supplying the vaso-motor centres, gives the stimulus which results in the periodic contraction of the peripheral vessels. If the rigor be severe the vessels of the superficial muscles are also affected, and those of the internal organs become abnormally full. Hence the temperature of the surface falls, and that of the deeper parts of the body rises.
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