A theoretical and practical treatise on the diseases of the skin / by P. Rayer.
- Pierre François Olive Rayer
- Date:
- 1845
Licence: Public Domain Mark
Credit: A theoretical and practical treatise on the diseases of the skin / by P. Rayer. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![I suppuration ; bul this is above all in the Arabian elephantiasis, in syphilitic affections accompanied with morbid growths, in some nari, in ichthyosis, and in one variety especially of this dia rved in individuals who have been . thai the elongation of the papilla becomes Some pathologists have supposed that j rurigO was caused In inflammation of the papilla'; but this assump- tion h D supported b\ any anatomical tacts. The disease imonly on the outer parts of the thighs or arms, and in the shoulders, situations in which the eve does not detect nume- rous papilla?, and is never seen attacking the cushions of the lingers, ■ S, or where they are very conspicuous. The foep-seated epidermic layer (couche albide prqfonde, Gard- ner), which cannot usually be perceived in the human skin, I have -■en very distinctly in some cases of Arabian elephantiasis. It is ly like the external epidermis. I am not aware whether it undergoes any modification in other cutaneous affections or not. 11. Thi' piffiru at or n te-mucosum1 is altered in the greater number menus inllammations; for a certain quantity of blood is almost always deposited beneath the epidermis, in the epidermic layer of the papillae when it exists, on the surface, or in the substance of the der- veii the exanthemata sometimes exhibit these bloody suffusions. From the quantity of blood deposited, and the amount of its elements imbibed by the skin, result spots or stains of a brown, livid, coppery, or yellowish-gray colour, &.C., which continue for a longer or shorter space of time according to the age and the constitution of the indi- vidual affected, the nature of the disease, and the means of cure employed. 42. The epidermis3 undergoes numerous alterations at the decline or during the course of many inflammations of the skin ; it becomes dry and brittle, and then it chaps and splits, or is detached from the true skin in the form of bran, scales, or plates, and sometimes in large flaps from regions where it is thicker or stronger, as it is on the soles of the feet, the palms of the hands, the knees, the elbows, &c. Its detachment is rarely followed by the fall of the nails, but most com- monly by that of the hair. The colour of the epidermis may undergo several modifications.— It grows yellowish in some syphilitic affections, black in one variety yriasis, of a dull wliite in lepra, and of a pearly hue in some pityriases of the hairy scalp. The increase or diminution in the thick- iii the transparency, and in the tenacity of the epidermis all furnish important characters in the determination of species. 13. The sebaceous follicles3 are attacked by diseases peculiar to themselves.'' They become altered in many affections which were pri- marily unconnected with them. The parts of the skin most frequently inflamed are also those that are most amply provided with follicles. The history of eczema, of impetigo, of favus, of acne, of rosacea, &C., demonstrates how frequently inllammations of the follicles occur, and how various these diseases are in their characters. The follicles of the chin in man are subject to a very intractable species of pustular inflammation—sycosis menti. The follicles of the pubes are more rarely affected than those of any other region of the body. 1 B. S. Albinus. De sede et causa colorisjEthiopum et coeteroruro hominum. Lugd, ltaiav., 1737, et Annot acad., lib. L, cap. li.—Soemmering. Ueber die kccperliche Ver- -chiedenheit des Negers vom Europaer.—Everard Home. On the black colour of the rete mucosum, (Phil. Trans., 18.)—Heusinger. Recherches sur la production acci- ilentelle da pigment et du carbone dans le corps humain (in German). Eisenach, I 833.—An extract will be found in the Archives gen. de medecine, t. v., p. 290.—Marx. Sur le pigruentum de la peau des negres (Bullet, des sciences medicales de Ferrus- sac, t. xvii.. p. 322.)—Leidenfrost. Diss, de statu prceternaiurali succi retis Malpigh- .•ani. Dnisburg, 1771. - 11. Pabricius. De totius animalis integumentis. ac primo de cuticula, et iis qua? ■■upra cuiicuUiin sum; inOpcr. omn.—Ludwig. De cuticula: Leipsicc, 1739.—Meckel. i l'cpiderme (Mem. de l'academie royale des sciences de Berlin, annee 1757).—Monro. De cuticula humana; in his Works, Edinburgh, 1781.—J.-Th. Klin- i Hermann. De veia naturi cuticula?, ejusque reseneratione. Pragoe, 1775. — I!. Mojun. SulP epidermide, etc. Genoa, 1815.—Chiaje (S.) Osservrazioni sulla struttara della epidermide umana. Napoli, 1827. • J. Ch. Rensa (presid. Autenrieih). De glandulis sebaceis. Diss. Tubinga>, 1807. — Weber. Sur les follicules sebaces (Journ. coropl., I. xxix., p. 138).—Eichhorn, Sur de la peau et sur lea roies par lesquelles elles s'operent, (Bulletin des stcience* de Ferussac. t. xi., p. 15,) has maintained that the sebaceous fol- ive no existence as peculiar organs, and that the sebaceous matter of the skin by the hairy follicles; we see, however, that the follicles of the glans, i.nd those of ihe skin generally, of many animals, never produce hair. ' Ka De fuUkaloram sebaeeorum morbis, in-8, Rovtock, 1828. •It. The. fttjfta-willbelasl described. To the diseases generally known to affect these minute organs, favus must be added. The hair-bulbs of the genital parts and axilla' are more randy dis- eased than those of the face and sea!]). In the axilla, especially, the hair-follicles are deeper and larger than anywhere else, and their inllammations are always more than usually severe and rebellious m their nature. 45. I shall, by and by, describe those alterations which the nails experience when the skin which they cover is attacked by lepra, eczema, psoriasis, syphilis, &c. 46. The relative frequency with which cutaneous inllammations occur on the right and on the'left side of the body, is a subject which, if not very useful, is at least curious. When I treat of zona, icterus, &C., I shall present the remarks of Mehlis on this subject,5 and point out certain errors into which he has fallen, his calculations not having been made on data sufficiently extensive. 47. Some forms of inflammation are set up indiscriminately on every part of the surface:—such are erythema, ecthyma, and others ; but many of the same class of maladies affect certain regions especially: eczema shows itself on the hairy scalp, on the cars, and on the margin of the anus; prurigo affects, in preference, the outer parts of the limbs; lupus attacks the cheeks and ala? of the nose ; rosacea, sycosis, and acne, regarded as modifications of the same disease, invade the face, the chin, and the integuments of the trunk ; others, again, con- stantly occupy the whole, or almost the whole, surface of the body at once ; such are measles, scarlatina, &c. 48. The etiology or doctrine of the causes of cutaneous inflamma- tion, has been the subject of much research. The roots, to use an old and characteristic expression, of certain local diseases of the skin, such as warts, follicular tumours, horny appendages, &c, were dis- tinguished at a very early period to be internal. To approach as nearly as possible to a true knowledge of the causes of cutaneous disease in general, it has been found necessary to study not only the nature and the effects of external stimuli on the skin, but, further, the relations of the skin to the principal organs of the economy,6 and the influence of diseases on affections of the integuments. 49. Thus studied and compared in their causes, their progress, their termination, their treatment, and their nature or mode of exist- ence, inflammations of the skin fall naturally under two categories. Those of the one, essentially local, and produced by external evident causes, are easily and promptly cured ; those of the other, developed without any appreciable outward cause, appear linked to morbid states of the system,—to more or less complex conditions of the organization, of which they are only, so to speak, symptomatic expressions; thus we say scrofulous lupus, purpura hemorrhagica, cic. 50. Natural excretions, or other matters, deposited on the surface of the skin,—the scurf of the hairy scalp, in pityriasis capitis, for example, the matter of the perspiration in intertrigo aurium, the mu- cous discharge in the same disease of the thighs, the contact and fric- tion of the dress, garters, corsets, &c.,7 and a multitude of irritating substances, such as mustard, cantharides, tartrate of antimony, Bur- gundy pitch, croton oil, &c, excite particular inflammations, which appear under various forms,—exanthematous, vesicular, or pustular. 51. Many chronic inflammations are caused by want of cleanliness. It was partly to this cause that Willan attributed the great number of cutaneous diseases, observed in London, among the iower classes of society. The frequency of skin complaints, or of itch, at least, among the inhabitants of lower Brittany, is due to the state of filth in which they live, and to the ease with which this disease is communicated. It seems certain that prurigo, and several artificial forms of inflam- mation, would be less common among the poorer classes, were they not compelled, by necessity, to neglect the use of baths and other similar means of preserving health, which their laborious occupations often render more particularly necessary. 5 Mehlis (C. F. Ed.). Comment, de morbis hominis dexlri et sinistri; 8, 1817. (J. Frank. Delectus opusculorum, vol. i., Novocomi, 1827.)—Cartereau (E.F. » la symmetric dans le corps de l'homme, these, in-4. Paris, 1823. c Lorry. De morbis cutaneu—Art. vi. Desensu cutis ad alias partes rclativo- seu cutis cum aliis partibus consensus.—p. 25. ' Sauvages numerat erysipelas in eule nascens a rollarium ecclesiasticorn (Lorry. De morbis cutan., p. Of )](https://iiif.wellcomecollection.org/image/b21149495_0030.jp2/full/800%2C/0/default.jpg)
