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.
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![LUPUS AND SCROFULOUS ULCERATION. and coalesce, forming large maeulre which have not the circular form which pityriasis usually presents. In what is called bronzed skin, the whole body becomes gradu- ally of a brown colour, sometimes variegated here and there by portions of natural colour. This condition has been thought of late years to be perhaps connected with disease ot the supra- renal capsules. We need not allude to the congenital peculiarities of naivi, or the freckles of early life : neither does the deficiency of colour in the albino belong to conditions of disease. Occasionally white spots are developed in advanced years, especially on the scrotum of old men known as vitiUyo, the true nature of wliich is as yet not understood. It does not seem connected with disease properly so called. § 10. Lwpus and Scroftdous Ulceration. — Tliough generally regarded as L(donging to the domain of surgery, these diseases are evidently of constitutional origin, and their characteristics ought at least to be known to the physician. There seems reason to believe that they belong to the same diathesis, and are chiefly modified by the age of the patient. They are marked by the same general feature of indolence and unwillingness to heal, by the inefficiency of local treatment, and by their being both modified by the same internal remedie.s. Lupus is more distinctly cutaneous ; it is superficial, and shows a great ten- dency to spread. Scrofulous idcer is always preceded by abscess, and can oidy be regarded in a secondary sense as a disease of the skin. Lujms may arise in several ways, and it is only the constitutional cachexia which, modifying its subsequent course, gives it a s]>ecific character. Its seat is most frequently about the ahe of the nose, the lij)s, and the cheeks. Its commencement may be referred to three ]n-incipal varieties of cutaneous eruption, the vesicular, the pustular, and the tubercular ; occasionally re- sembling herpes, it more usually begins like a sj)ot of impetigo ; and when it attacks the cheek, it sometimes presents the form of tubercles. In the eaily stage it differs from the two former by its insidious commence- ment and slower progress, by the firm adhesion of the iTnCinnTTrrTTrjnniTTTTtTZItEinFTwTTTTFSKJIirif](https://iiif.wellcomecollection.org/image/b24989812_0609.jp2/full/800%2C/0/default.jpg)
