Monthly retrospect of the medical sciences : January to December 1849 / edited by George E. Day, Alexander Fleming, W.T. Gairdner.

Date:
MDCCCXLIX [1849]
Catalogue details

Licence: Public Domain Mark

Credit: Monthly retrospect of the medical sciences : January to December 1849 / edited by George E. Day, Alexander Fleming, W.T. Gairdner. Source: Wellcome Collection.

    9/262 (page 7)
    water.— Trans. Amer. Med. Assoc., vok i. p. 135. [The ocdematous parts are thus disgorg¬ ed, and the respiration is so much relieved as to afford time for the operation of other remedies, and the necessity of resorting to tracheotomy may be obviated. 6.—Localization of Cutaneous Disease. By Dr C.Baron, Jun.—Dr B. forms ten distinct classes, according to the anatomical ele¬ ment of cutaneous disease. The first com¬ prises the disorders of the vascular system —roseola, measles, scarlatina, erythema, &c. Their principal character consists in redness, and in many of them the presence of feverishness shows the participation of the general circulation in the disturbance of the capillary sjstem of the surface. In scarlatina, according to our author, it is the venous capillary net-work which is in¬ flamed, or rather congested ; the venous arterial and lymphatic elements are in¬ flamed in erysipelas ; a chronic inflamma¬ tion of the superficial vascular layers con¬ stitutes pemphigus. Their preternatural development is observed in nsevus, and if the deeper-seated vessels are increased in size the disease acquires the nature of erectile tumours. 2. The papilte are the organs of cuta¬ neous sensation; their diseases will, there¬ fore, be accompanied by increased or dimi¬ nished local irritability, and the excessive pruritus of urticaria and prurigo, induce Dr B. to class them amongst disorders of the papillary system. In elephantiasis sensation is at first deadened, and the pa¬ pillae hypertrophied. 3. Affections of the sudoriferous system are generally observed in young subjects. They are attended usually with feverish¬ ness, and either consist in augmented se¬ cretion, as in miliaria and sudamina, of in¬ flammation of the sudoriferous organs and capillaries of the vicinity, or in the in¬ flammation of their ducts as in herpes. 4. Maladies of the blennogenic system (secretion of epidermis) are habitually chronic and tenacious ; almost in all cases the secretion of epidermis acquires an un¬ due degree of activity ; simple congestion constitutes pityriasis, inflammation, ecze¬ ma, chronic inflammation, and slight indu¬ ration, psoriasis ; perversion of secretion, ichthyosis ; increased abundance of secre¬ tion, and of hardness of epidermis, bunions, and corns. The fifth class consists of perversion of functions of the chromatogen or colouring apparatus. The sixth is one of the most important, comprising the maladies of the follicular system, i. e., the varieties of acne and impetigo. The seventh class refers to diseases of the organs of secretion of hair, amongst which M. B. places lichen. The eighth class, which scarcely deserves that name, and might perhaps be blended in the fourth, is consecrated to diseases of the organs of secretion of nails. The ninth division has more extent and more impor¬ tance. It is constituted by maladies of the fibro-cellular texture of the dermis, such as ecthyma, rupia, variola, furuncu- lus ; and, finally, the tenth class charac¬ terised by the lesion of several anatomical elements of the skin in scabies. —Acad, de Medicine; Dr McCarthy’s Report in Med. Times, Nov. 25, 1848. [Dr Baron’s classification is a very good plaything, but is entirely useless and un¬ practical. It is deeply imbued with the error of all so-called pathological classifi¬ cations; that, while professing to be found¬ ed exclusively on facts, it in reality com¬ pels the mind to rest upon much which is wild hypothesis, if not positive error. Very much of Dr Baron’s system must be placed in these categories. Why, for instance, is the “ congestion” of the superficial vessels which exists in the exanthemata, treated as of such primary importance in most of them, and overlooked in urticaria 1 How does “ simple congestion” of these vessels constitute pityriasis (class 4), while the same simple congestion is equally the pa¬ thological cause of scarlatina (class 1) ? Why are the different phenomena of ec¬ zema and psoriasis (class 4), referred to ex¬ actly the same pathological cause, chronic inflammation with increased secretion of epidermis ? These are only a few of the questions which might be asked, but they are sufficient to show that precision, the great object of all classification, is not ad¬ vanced by this system, while by “ assum¬ ing a virtue ’’ which it has not, it bars the way to further improvement.] 7.—On the Antagonism of Gout and Phthisis. By Dr Garrod.—The gouty diathesis has been supposed inimical to the development of tubercular disease. It is true they are rarely combined in the same individual; but this is easily ac¬ counted for by the fact, that gout, in ge¬ neral, does not appear until the age of forty, whereas tubercular disease is much more frequent before that period. But cases do occur in which the two diseases coexist; and the following very interest¬ ing example is related by Dr Garrod:— A young man, aged twenty-eight, a native of London, whose father and grandmother