Licence: Public Domain Mark
Credit: A manual of medical diagnosis / by A.W. Barclay. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
608/642 page 584
![redness nor tlie occasional mixture of blood with the ])us, which is common in ecthyma. When the disease assumes these suppurative forms, idceration of the angle of the lips is uot uncommon, and greatly confirms tlie diagnosis. Its discrimination from rupia is less important, because tlie same ti-eatment which is called for in the one is equally suitable to the other ; but it is less frequently like true rupia than intermediate between that and ecthyma. Coincident with any of the foregoing eruptions, especially when their chai’acter is pustular, we some- times find deep burrowing ulcers on the face, and at tlie aim of the nose, resembling lupus, or there may be ozrnna from commencing disease of the bones of the nose, with soi'eness of its lining membrane. Congenital syphilis is chiefly marked by ulcers at the angles of the mouth, cracked lips, running of the nose, “ snutfles,” condylomata, and ulceration of the anus and pudendum, with emaciation. In reference to tlie copiier-colonr of sjpliilitic eruptions, a few words may be added on the subject of cutaneous discoloration generally. As an objective plienonienon it forms the direct ex- ponent of purpura and of jaundice, and is tlie chief feature of amemia and chlorosis : it helps us to distinguish measles from scarlatina, and it materially aids our diagnosis of cancer, and of disease of the heart and kidneys. In other cases the change of colour is more distinctly confined to the skin itself, as when, for example, a dusky grey or blue colour is jirodnccd by the internal use of nitrate of silver. In some persons the existence of any simple cutaneous disease, e.</., herpes, or lepra, is always followed on its decline hy a hrown stain, which lasts long after the skin has acipiircd its natural condition in all other respects, and this is particularly the case with persons of a dark complexion: it is the very same change as is seen after syphilitic affections, except that the colour in the latter may be much darker, and commonly lasts for a longer period. In others, again, patches of a hrowm or yellowish colour form, which have been called ephelides, from their supposed connexion with sun- burning : they are very like syphilitic stains, e.xcept that they are scarcely so dark, and they have not hecn preceded by any other eruption. In their commencement they resemble pityriasis versicolor, except in the absence of branny scales and roughness. They begin with small spots like freckles, which gradually enlarge](https://iiif.wellcomecollection.org/image/b24989812_0608.jp2/full/800%2C/0/default.jpg)
