Manual of diseases of the skin / from the French of Cazenave ; with notes and additions by Thomas H. Burgess.
- Pierre Louis Alphée Cazenave
- Date:
- 1854
Licence: Public Domain Mark
Credit: Manual of diseases of the skin / from the French of Cazenave ; with notes and additions by Thomas H. Burgess. Source: Wellcome Collection.
43/446 page 33
![eczema—errors which aie, even now, by no means unfrequent— may cause great nneasiness in families ; or mistaking a simple érup- tion for a sypbilitic one, or overlooking tbe latter wben it does esist, bas often caused serious evils. In diagnosis consists tbe entire study of diseases of the skin. We sball, tberefore, endea- your to lay down some general rules for our guidance. * Tbe cbief point is to détermine tbe elementary lésion; tbis done, we bave merely to compare tbe disease witb tbe few which possess tbe same elementary cbaracters. In cases where tbe elementary lésion re- mains unaltered, we bave simply to ascertain whether it be a papule, vesicle, scale, &c. and tbis generally is a very easy task. Our next step is to détermine tbe species, and bere we are aided by the forin, seat, progress, &c. of tbe éruption. For example, a patient bas on tbe inner side of tbe arm, between tbe Angers, &c. a number of small collections of sérum, distinct, acuminated, transparent at tbe point, and accompanied by itch- ing, &c. On carefully examining, we find that tbe élévations contain no pus, that tbey are not solid and resisting, that they are not papular eminences covered by a scale, nor an injection of tbe skin wkich disappears under pressure ; tbe disease is tberefore vesi- cular. We bave tben to find out to wbat species of vesieular affec- tion it belongs. And in carrying out tbis process of élimination we soon arrive at a positive diagnosis. It is neitber miliaria nor vari- cella, which are accompanied by constitutional symptoms ; and besides in tbe former éruption tbe vesicles are globose andnumerous ; in tbe latter, larger and more iuflamed : it is not herpes, for in herpes tbe eminences are collected together in groups, while in tbe présent case tbey are diffused : it must therefore be eitber eczema or scabies ; but it is not eczema, for tbe vesicles of eczema are flattened, while bere they are acuminated : in eczema tbey are generally more or less agglomerated, while bere tbey are distinct; ercjo, it is scabies. Tbe example wbicb we bave just given is a simple one • but tbe diagnosis is sometimes more difficult, even wben tbe elementary character of tbe disease remains in part : tbus scabies, wbicb is of W-nhe TT T “ 77 laSt editi0n’ U iS “ dia^09is the olaesification P 7 ? advantaee6 ■ for- “3 they truly remark, if anatural classification should hereafter be foi-med, that of Wülan will always be retamed for the purpose of diagnosis.] ^ D](https://iiif.wellcomecollection.org/image/b28049573_0043.jp2/full/800%2C/0/default.jpg)
