Selected essays and monographs : translations and reprints from various sources.

Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Selected essays and monographs : translations and reprints from various sources. Source: Wellcome Collection.

    188/476 (page 172)
    disease is illustrated by two plates. We are not surprised at this view, for it was the one held by our revered teacher, Prof. Hebra. In the same year H. Auspitz described the affection as herpes vegetans, and he also maintained its syphilitic nature. We are thus able to account for the absence of any reference to pemphigus vegetans in the literature of pemphigus, and at the same time understand how more recent writers, including Hebra, have overlooked the nature of this puzzling and rare disease. The case I published in 1876 was the turning-point in our views. It was at first regarded by Hebra as well as by myself to be syphilitic in nature. Later on, Prof. Bamberger saw the case; he considered it to be a severe form of pemphigus vegetans. The following are the details :— In January, 1875, Prof. Politzer called me in to see Mrs. B. She had always enjoyed good health up to the end of November, 1874, when the first symptoms of the disease appeared. It consisted of isolated blebs in the right axilla, which on bursting left exposed a raw moist surface. The sores were most rebellious to treatment; in fact, they showed no tendency to heal, in spite of various applications—ointments and caustics. The patient was 81 years old, robust, well nourished, but complained of great discomfort on swallowing. The first time 1 saw the patient there was in the right axilla a dusky-red raised area, half-a-crown in size, destitute of epidermis. Its surface was furrowed, granular, and bathed in serous discharge. At the end of a week the granulations had increased so as to be 2 cm. above the surrounding skin level. Plencke’s solution* and caustic potash had no effect whatever. The mucosa of the lower lip was now attacked, flat blebs appeared, rapidly drying into crusts. On removal of these a firm adherent slough was disclosed. The eruption spread to the mucosa of mouth and fauces, so that the patient could only take fluid food. The temperature of the skin was normal, bowels regular, menstrua- tion scanty, and the urine free from albumen. As the axillary vegetations were uninfluenced by treatment, and their condyloma- like appearance became more striking, the specific nature of the affection was, so to say, confirmed. Examination of the husband * Plencke solution—equal parts by weight of mercuric perchloride, alum, lead, carbonate, camphor, spirits of wine, and vinegar. [Trans.]