Essentials of Diseases of the Skin.

by Henry Weightman Stelwagon.

PREFACE TO FIRST EDITION.

Much of the present volume is, in a measure, the outcome of a thorough revision, remodelling and simplification of the various articles contributed by the author to Pepper's System of Medicine, Buck's Reference Handbook of the Medical Sciences, and Keating's Cyclopaedia of the Diseases of Children. Moreover, in the endeavor to present the subject as tersely and briefly as compatible with clear understanding, the several standard treatises on diseases of the skin by Tilbury Fox, Duhring, Hyde, Robinson, Anderson, and Crocker, have been freely consulted, that of the last-named author suggesting the pictorial presentation of the "Anatomy of the Skin." The s.p.a.ce allotted to each disease has been based upon relative importance. As to treatment, the best and approved methods only--those which are founded upon the aggregate experience of dermatologists--are referred to.

For general information a statistical table from the Transactions of the American Dermatological a.s.sociation is appended.

H.W.S.

DISEASES OF THE SKIN.

ANATOMY OF THE SKIN.

[Ill.u.s.tration: Fig. I.

Vertical section of the skin--Diagrammatic. (_After Heitsmann._)]

The Epidermis.

[Ill.u.s.tration: Fig. 2.

_c_, corneous (h.o.r.n.y) layer; _g_, granular layer; _m_, mucous layer (rete Malpighii).

The stratum lucidum is the layer just above the granular layer.

Nerve terminations--_n_, afferent nerve; _b_, terminal nerve bulbs; _l_, cell of Langerhans. (_After Ranvier._)]

The Blood-vessels.

[Ill.u.s.tration: Fig. 3.

_C_, epidermis; _D_, corium; _P_, papillae; _S_, sweat-gland duct.

_v_, arterial and venous capillaries (superficial, or papillary plexus) of the papillae. Deep plexus is partly shown at lower margin of the diagram; _vs_--an intermediate plexus, an outgrowth from the deep plexus, supplying sweat-glands, and giving a loop to hair papilla.

(_After Ranvier._)]

The Nervous and Vascular Papillae.

[Ill.u.s.tration: Fig. 4.

_a_, a vascular papilla; _b_, a nervous papilla; _c_, a blood-vessel; _d_, a nerve fibre; _e_, a tactile corpuscle. (_After Biesiadecki._)]

The Hair and Hair-Follicle.

[Ill.u.s.tration: Fig. 5. _A_, shaft of the hair; _B_, root of the hair; _C_, cuticle of the hair; _D_, medullary substance of the hair. _E_, external layer of the hair-follicle; _F_, middle layer of the hair-follicle; _G_, internal layer of the hair-follicle; _H_, papilla of the hair; _I_, external root-sheath; _J_, outer layer of the internal root-sheath; _K_, internal layer of the internal root-sheath. (_After Duhring._)]

SYMPTOMATOLOGY.

The symptoms of cutaneous disease may be objective, subjective or both; and in some diseases, also, there may be systemic disturbance.

What do you mean by objective symptoms?

Those symptoms visible to the eye or touch.

What do you understand by subjective symptoms?

Those which relate to sensation, such as itching, tingling, burning, pain, tenderness, heat, anaesthesia, and hyperaesthesia.

What do you mean by systemic symptoms?

Those general symptoms, slight or profound, which are sometimes a.s.sociated, primarily or secondarily, with the cutaneous disease, as, for example, the systemic disturbance in leprosy, pemphigus, and purpura hemorrhagica.

Into what two cla.s.ses of lesions are the objective symptoms commonly divided?

Primary (or elementary), and Secondary (or consecutive).

Primary Lesions.

What are primary lesions?

Those objective lesions with which cutaneous diseases begin. They may continue as such or may undergo modification, pa.s.sing into the secondary or consecutive lesions.