Wimple

“ The hair becomes white and woolly, and at length falls off; hard gelatinous swellings are formed in the cellular tissue; the skin gets hard, rough, and seamy, lymph exudes from it, and forms large scabs, which fall off from time to time, and under these there are often offensive running sores. ”

“ The patches grow slowly, are milky or dead white, smooth, non-elevated, and of rounded outline; the bordering skin is darker than normal, showing increased pigmentation. Several contiguous spots may coalesce and form a large, irregularly-shaped patch. Hair growing on the involved skin may or may not be blanched. ”

“ In the course of the next four-and-twenty hours in some cases, and in others not until the expiration of two or three days, it completely covers the body; not being confined exclusively to the skin, but frequently extending to the mouth and throat, and even to the external membrane of the eye.
In the course of two or three days from their first appearance the little pimples, increasing in size, will be found to contain a thin transparent fluid, to pit or become depressed in their centre, and the skin in the spaces between them will be found red. ”

“ As observed on the fingers of adults, the affection takes the form of an indolent painless swelling, the epidermis being red and glazed, or warty, and irregularly fissured. Sometimes the epidermis gives way, forming an ulcer with flabby granulations. The infection rarely spreads to the lymphatics, but we have seen inoculation tubercle of the index-finger followed by a large cold abscess on the median side of the upper arm and by a huge mass of breaking down glands in the axilla. ”

“ Pimples on the face are usually due to obstruction of the sebaceous glands; sometimes the obstruction leads to inflammation around the sebaceous gland (acne) which often permanently injures the skin.
2. Accumulation of effete matter on the skin occurs, unless frequent ablutions are performed. The epidermis is constantly shedding its older and more superficial parts, in the form of minute scales or “scurf.” In the absence of frequent washing, the scales of epithelium tend to accumulate, the sebaceous secretion matting the scales together, and rendering them more adhesive. ”

“ The inflammation subsides, but some of the swelling remains in dependent members of the body, arms, legs, breasts, vulva and scrotum. These swellings may be caused by dead filaria worms, which block the glands whose function it is to drain a dependent area; thus the dead worms might impede the return flow of lymph and cause an overgrowth of skin and subcutaneous tissue, slowly piling up to a huge size. The skin grows rough like an elephant’s hide, and the monstrous limbs add to the elephantine look. ”

“ In certain diseases of nervous origin, notably in herpes zoster, the eruption follows the course of a certain nerve. In the face we get erythema, lupus erythematosus, rosacea, eczema, actinomycosis, &c, and syphilitic and malignant ulcers. Rodent ulcer usually selects the face, and generally the nose or orbit. The face too is usually the selective site of lupus vulgaris. The scalp is the chief site oi two varieties of lesion — the pustular, as in pustular eczema and impetigo contagiosa, or the dry and scaly eruptions, as psoriasis, ringworm and squamous syphilides. ”

“ Usually the earliest appearance of the sore is similar to that of a mosquito bite. The papule continues to enlarge, becoming purplish in color with a glazed surface. It somewhat resembles an inflamed acne lesion. Growing larger, the surface of the blind boil-like lesions now becomes covered with brownish scales and, either from scratching of the rather pruriginous spot or from the development of vesicles, it becomes covered with a yellowish crust, beneath which is an ulcer with raised edges and discharging a thin offensive pus. ”

“ The lining membrane of the nostrils is covered with papules similar in character to those on the skin, which form ulcers, and may lead to the destruction of the cartilaginous and bony textures of the nose. The diseased action extends into the throat, mouth and eyes, while the whole face becomes swollen and erysipelatous, and the lymphatic glands under the jaws inflame and suppurate. ”

“ Pimples, or blackheads, appear as small elevations in the skin, with a small black point in the center. The cause of the pimple is the alteration in the quality of the sebum, the oily secretion, which becomes and remains a hard mass in the excretory ducts of the sebaceous glands and plugs up its external opening. The dust of the air becomes mixed with the fat, and thus makes a black point. When the ducts cannot get rid of the sebum, they become stopped up, and in consequence become swollen. This irritation spreads to the adjacent tissues, and so inflammation arises. ”

“ The nature of scalding then, is this: the hot water coming upon the body, separates immediately the scarf skin from the real skin, thereby opens the lymphatic vessels, so that they discharge their lymph under the cuticula, and thence arise blisters. But withal, the heat of the water irritating the nerves, they are excited to contract and constrict the delicate vessels, and hinder the circulation; thence ensues the fiery colour and inflammation, and create acrimonious tendencies. Thence we learn, that a relaxation of the solids is to be relaxed, and the humours to be rectified. ”

“ Cause: bacillus. Symptoms; incubation 6 to 15 days, skin tenderness, heat, swelling like peas, hazel nuts, vesicles, pustules, exudation, concretions among hairs, depilation, healing in 15 days. Leaves white spots with lighter hair. Extension by grooming: general eruption: subcutaneous swelling, sloughs, delayed healing. Lymphangitis. Diagnosis: from chaps and bruises, from horse pox, from impetiginous eczema, from urticaria, from farcy. Prevention, quarantine new horses, separate diseased, disinfect skins of the unaffected, disinfect stables and harness. ”

“ Affections of the Skin.—Although all types of skin affection are met with in the inherited disease, the most important is a papular eruption, the papules being of large size, with a smooth shining top and of a reddish-brown colour. It affects chiefly the buttocks and thighs, the genitals, and other parts which are constantly moist. It is necessary to distinguish this specific eruption from a form of eczema which occurs in these situations in non-syphilitic children, the points that characterise the syphilitic condition being the infiltration of the skin and the coppery colour of the eruption. ”

“ There is at first redness, usually of the bridge of the nose and it rapidly spreads to the cheeks, eyes, ears, etc. It is red, shiny hot, drawing, but with a distinct margin at its edges, showing how much skin is inflamed. It may take the form of vesicles. The eyelids may be so swollen as to close, the face and scalp greatly swollen with watery swelling of the eyelids, lips, eyes, ears, etc. The glands under the jaw may become enlarged. The general or constitutional symptoms may be severe. ”

“ Describe the symptoms and course of prurigo.
The disease first appears upon the tibial regions, and its earliest manifestation may be urticarial, but there soon develop the characteristic small, millet-seed-sized, or larger, firm elevations, which may be of the natural color of the skin or of a pinkish tinge. The lesions, whilst discrete, are in great numbers, and closely crowded. The overlying skin is dry, rough and harsh; itching is intense, and, as a result of the scratching, excoriations and blood crusts are commonly present. ”

“ The distinguishing feature of this group of cutaneous affections is the formation of bullæ, or blebs, which are defined as "eminences of the cuticle, containing a fluid."
Herpes is an inflammation of the skin in which the eruption appears in patches of a circular form. On the second day, minute, transparent vesicles appear and gradually develop, becoming opalescent. On the succeeding days, they shrink and produce reddish brown scabs, which soon become hard and fall off, leaving deep, purplish pits. ”

“ Irregularly scattered over the face, and in some cases also over the neck, shoulders and upper part of the trunk, are to be seen several, fifty or more, pin-head- to pea-sized papules, tubercles or pustules; commonly the eruption is of a mixed type (acne vulgaris) , the several kinds of lesions in all stages of evolution and subsidence presenting in the single case. Interspersed may generally be seen blackheads, or comedones. The lesions may be sluggish in character, or they may be markedly inflammatory, with hard and indurated bases. ”

“ Usually on the second day of the disease, the face, neck, breast and hands to the tips of the fingers became of a deep erysipelatous colour with perceptible swelling, the fingers in particular being often of so characteristic a tint as at once to suggest an examination of the throat. A great number of small pimples, of a deeper red than the skin around them, appear on the arms and other parts; they are larger and more prominent in those subjects, and in those parts of the same subject, where the redness is least intense, which is generally on the arms, the breast, and lower extremities. ”

“ It begins in very small papules or minute red pimples, which rapidly multiply, and these run together into patches which have a tendency to a horse-shoe, or crescent, shape, while the portions of skin between are of a natural colour. Commencing on the face and neck, the blotches spread to the arms, then the trunk of the body, and gradually reach the lower extremities. ”

“ In inflammations of a high type, in those occurring on the skin or mucous membranes in which there is an extraordinary increase of nuclei and embryonal cells, and in lymph thrown out in excess at one point, so that its central parts are far from vascular tissue and nourishment, the cell elements undergo a rapid increase and degradation into pus-corpuscles, and its solidified intercellular lymph undergoes granular decay and liquefaction into pus. ”

“ After the eruptions or ulcers are healed a solution of corrosive sublimate of one grain to an ounce of water applied for some weeks behind the ear, and amongst the roots of the hair on one side of the head, where the mouths of the lymphatics of the neck open themselves, frequently removes these tumours. ”

“ In contrast to ordinary dropsy, there is no pitting on pressure, and the swelling does not disappear on elevation of the limb. The skin becomes rough and warty, and may hang down in pendulous folds. Blisters form on the surface and yield an abundant exudate of clear lymph. From neglect of cleanliness, the skin becomes the seat of eczema or even of ulceration attended with foul discharge. ”

“ The body is hot; breathing short; a clear mucous flows from the mouth; the parts occupied with pimples, especially the head, swell so that the animal cannot open its eyes or mouth; the fever continues; the pustules enlarge, and are filled with fluid, first thin, and then becoming thick, yellow and purulent. ”

“ I preserved a great part of the skin of a man who died at the Hôtel Dieu, and his epidermis, which was treble the thickness from his birth and even in the womb of his mother, that it is in the ordinary state, had been subject during his life to a continual desquamation which made the whole of it appear as if covered with herpes, though nothing similar to this affection existed upon the dermis, which was perfectly sound. ”

“ When pus is formed in a well-maintained system and tissue, the outer layer of the lymph is developed into a fibrous sac enclosing the liquid pus and constituting an abscess. In an unhealthy system, or when the inflammation depends on some injurious poison, like that of erysipelas, this sac may not be formed, and the pus, burrowing into and between different organs, destroys the connections and substance—diffuse suppuration. ”

“ If choking is threatened, give an emetic of mustard, one teaspoonful, and warm water, half a pint.
PIMPLES; BLACKHEADS (Acne) .—This eruption is situated chiefly on the face, but often on the back, shoulders, and chest as well. It is a disorder which is seen mostly in young men and women at about the age of puberty. It consists of conical elevations of the skin, from a pin head to a pea in size, often reddened and tender on pressure, and having a tendency to form matter or pus, as shown by a yellow spot in the center of the pimple. ”

“ On the contrary, every child has sore places where the skin has been chafed, especially at the joints, and in folds and depressions of the body; half-healed scabs, where nature is getting the upper hand in spite of neglect; eyes nearly always bleared and running in consequence of the perpetual attacks of flies, and, finally, individual cases, here and there, of thrush-ulcers on such a scale that fungoid growths actually protrude from mouth and nostrils. ”

“ The whole of the scalp becomes hot and [Pg 81] swollen, and covered over a large surface by a thick dirty crust, through cracks in which a thick ill-smelling greenish-yellow matter exudes on pressure. At different points around, pimples form with mattery heads,—pustules they are called—while the glands on each side of the neck become swollen and tender. ”

“ In some cases the eruption assumes a papular character (see plate) , and numerous yellowish-red and slightly scaly discs are seen upon the buttocks, thighs, and face, and occasionally over the greater portion of the body. In rare instances the papules are small, flattened, and shining, and present a strong resemblance to lichen planus. Pustular lesions of an ecthymatous character are sometimes present, especially in infants who are ill-nourished and poorly cared for. ”