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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![table. It is well known Ct to cutaneous eruptions and to erysipi itic muscular exertions* on the - been observed by Lorry. habitual rest ami inaction is often accompanied by great . ,ni(l whit dtin ; and 1 have ascertained the beneficial influence which i 1 by the relaxation of the muscular system on the progress of diseases of the skin among the labourers and handicraftsmen received into our hospital. The opinion very generally diffused among persons labouring chronic affections of the skin, of their diseases being kept up by some alterations of the blood,2 by some morbid state of the humours, is strengthened by sundry observations. I have noticed thai the! blood was bully in a great many of these cases, even when was no fever, and no appreciable disorder in any of the prin- cipal functions. In anthracion or malignant pustule, in small-pox and measles, the blood is certainly charged with some principle of ion. Pujol assures us that the serum of the blood is bilious in ;l cutaneous diseases. It is very probable that certain agents only evert their influence on the integuments after having been carried into the torrent of the circulation. The inflammation of the skin in the mercurial disease, and the leaden hue that follows the long-con- tinued internal use of the nitrate of silver, are examples of the effects of such absorptions. As to the alterations of the lymph, and the acrimony of the serum, the mucus and the humours, which used to be universally admitted, almost all that has been written and taught on the subject, is hypothetical. I except those experiments that have been made on the contagious qualities of the fluids or matters of cow- pox, small-pox, scabies, of the nasal mucus in measles, &c. The appearance of many of these affections without appreciable cause, tbeir hereditary properties, their frequent recurrence and so forth, are so many circumstances which the alteration of the blood, were it demonstrated, would render less obscure. 64. The state of general plethora, observed in individuals of a sanguine temperament, whose skin is habitually ruddy, is more rarely the cause of cutaneous inflammation than the local plethora, produced by the stasis, or habitual or accidental afflux of a certain quantity of blood to any particular region of the surface of the body. ().). The relations between the skin and the organs of respiration, have been well obseryed by Meckel.3 Our knowledge, however, of the influence exerted by diseases of the organs of respiration on those of the skin, is confined to a very scanty number of facts. Alibert lias related two cases of eczema alternating with paroxysms of asthma. Hooping-cough is known to be occasionally followed by cutaneous eruptions, and phthisis often causes exhausting ephidrosis, and occa- sionally severe sudamina. tit). I have seen some chronic inflammations of the skin appearing only during pregnancy, such as eczema impetiginodes and prurigo, and others ceasing, or at all events, declining sensibly in their vio- lence during menstruation, pregnancy and nursing. In these cases, however, the diseases showed themselves anew on occasion of the suppression of the menses, or at the natural period of the cessation of this flux. I have observed eczema, and other chronic inflammations of the skin unexpectedly invading females who had been compelled by the death of their child or nursling, to give up nursing suddenly; these are the milk eruptions (dartres laiteuses) of certain writers. Similar cases have long been familiar in practice.4 67. Some authors tell us that the abuse of the sexual propensity may induce eruptions on the skin :(a) Lorry thinks they are more fre- (a) They are a common effect of masturbation. ' I'm'.e qui nimio motui, prosertim ante cetatem maturam indulgent, vultu varicoso ei pustulosA facie incedunt notabiles.si pracsertim latetintus acre superfluum (Lorry. De morb. cutan., p. 43). * J. F. Dieffenbach. Recherches physiolosjiques sur la transfusion du sang d'un chat Itpreux, du sang d'un cheval atteint de farcin, etc. (Journ. compl. des sc. med., lom. xxxiv., p. 113.]—Vide the art. rubeola, variola, icterus, anthracion, purpura, etc. ■ ckel. Diss. Pulmonum cum cute commercium illustrans. Halae, 1789. . pract, p. 26-7 (.Suppressio menstrnarum herpetum causa).— Unde fit ii mensiiuis deliiescentibus dimidia feminarum pars morbis afficiatnr cuta- kfi cutis ipsis magis antea nituent (Lorry. De morb. quently the effeel of an opposite cause. Certe, says he, utn- usque sexiis evolutione fact!, m castam instituerint vitaro erumprt vulgo ingens pustularum conglomerata congeries.1 Noting girls who suffer from these eruptions, and particularly from acne, are yen ittacked with rosacea at a later period of life. 08. Lorry informs us that pruriginous eruptions are sometimes seen to break out in individuals attacked with nephritis. Although my attention has been particularly turned to diseases of the kidneys for some years, I have not met with any case confirmatory of this assertion. 69. Not only do certain diatheses modify the characters of some cutaneous diseases, but they eminently predispose to the develop- ment of several of them. I have observed that scrofulous children, with thick lips, and heads of the shape of a calabash, were often affected with eczema impetiginodes of the face and hairy scalp, during the course of the first dentition. They are sometimes attacked with phagedenic affections (dartres rongewntes) of a very obstinate cha- racter, at the age of seven years, and about the period of puberty. 70. Among the causes of skin diseases, Galen mentions the arthritic virus; Ludwig7 points to the same source, and Lorry tells us that in families where the gout was hereditary, those individuals who escaped the disease, were subject to tettery eruptions. Pouteau, also, speaks of the influence of rheumatism in the development of cutaneous diseases. I am, myself, satisfied of the frequent alliance of diseases of the skin (dartres) with gout and rheumatism; I have seen these affections disappear suddenly, without any obvious cause, and the patients become the victims of the most violent pains in the articulations. 71. The hereditary nature of a great number of diseases, and particularly of many cutaneous affections, is one of the best established facts in pathology. It often follows the law of resemblance, and sometimes that of sex. 72. Some individuals, free from hereditary diseases, and apparently of a good constitution, are yet so subject to certain kinds of cutaneous inflammation, that Hufeland8 has seen fit to designate this condition by the title of Constitutio psorica, a denomination for which Jos. Frank has substituted that of Constitutio impetiginosa. I have myself given my advice to a great many persons in whom eczema, psoriasis, lichen, &c, appeared to be the effect of a constitutional predisposi- tion which was very difficult of removal, and which tended con- tinually to recur, independently of any accidental or other appreciable cause. 73. Several inflammatory affections of the skin may be congenital (erysipelas, variola, phemphigus); others appear especially in infancy (strophulus, pemphigus infantilis, roseola infantilis, measles, favus, &c), and others again are more commonly met with in old age (prurigo senilis, pemphigus pruriginosus, and so forth.) 74. According to Alibert, scavengers, and those who live habitually in air loaded with sulphurous vapours, are rarely affected with chronic inflammations of the skin.9 Some have also fancied that workers in charcoal, and those employed in preparing plumbago or black-lead were cured of the cutaneous diseases with which they happened to become affected, by the mere influence of their occupations. I have myself met with too many exceptions to these notions to have any doubts of their inaccuracy. Artificial vesicular and papular eruptions have been described under the name of grocer's itch, and baker's itch, which are either the consequences of local stimulants, or true eczemas happening in persons exercising these trades. Hydrargyria has been observed among the labourers in quicksilver mines. The trades that demand great muscular exertion and require the person to be exposed to high temperatures, render those that exercise them liable to sudden relapses of such complaints as eczema, lichen, rosacea, &c, a few days after apparent recovery from these affections. cut., p. 71.)—Dantur etiam mulieres quibus, dum tardias ernmpnnt mense* forfnra eminent simiha, cessantia simul ac copiosius ilii effluxerint. (Lorrv n 9* \ Lorry. De morb. cutan., p. 45. (Lorry, p. 98.) s Nee novum et inobservatum in nephritide, quoties calculus pundit renes et ore terum substantiam, pustulae prurientes ad cuiern orianiur. (Lorry Op en n fi<5 \ 7 Ludwig. Advers. de morb. arthrit. evolut., t. iii., p. 25.,-Lorry. De morb cutan p. 64.—Pouteau. CEuvres posthumes. cutan., 8 Hufeland. Journal der praktischen Heilkunde. 21. B. 4 St. S. 14. » Lorry was of a different opinion: Ssepe. herpelibus ant sordibus cutis morbos !i producendis fuit satis vicinia latrinarum. (Lorry. De raorb. cutan., p 86}](https://iiif.wellcomecollection.org/image/b21149495_0032.jp2/full/800%2C/0/default.jpg)
