Sex in Relation to Society
1893. She was the third of a family of 13 children of whom only five
775 words | Chapter 35
survived. Of the children born subsequently to the patient, the first
were either premature or died a few days after their births. The
seventh was under treatment for interstitial keratitis and tuberculous
ulceration of the lips and throat. The disease in the patient made its
appearance about seven months previously, as a small raised spot in the
middle of the back just above the buttocks. Many of the patches
coalesced. At the time of report the lumbar region was the seat of the
disease, the affection here presenting a most peculiar appearance,
looking as if an enormous butterfly had alighted on the patient's back,
with its dark blue wings covered with silvery scales, widely expanded.
The patient was not anemic and appeared to be in the best of health.
None of the glands were affected. According to Thomson there is little
doubt that this disease is caused by non-pyogenic bacteria gaining
access to the sweat-glands. The irritation produced by their presence
gives rise to proliferation of the connective-tissue corpuscles.
Jamieson reports a case of mycosis in a native of Aberdeenshire aged
thirty-eight. There was no history of any previous illness. The
disease began three years previous to his application for treatment, as
a red, itching, small spot on the cheek. Two years later lumps
presented themselves, at first upon his shoulders. The first thing to
strike an observer was the offensive odor about the patient. In the
hospital wards it made all the occupants sick. The various stages of
the disease were marked upon the different parts of the body. On the
chest and abdomen it resembled an eczema, on the shoulders there were
brown, pinkish-red areas. On the scalp the hair was scanty, the
eye-brows denuded, and the eyelashes absent. The forehead was leonine
in aspect. From between the various nodosities a continual discharge
exuded, the nodosities being markedly irregular over the limbs. The
backs of the hands, the dorsums of the feet, the wrists and ankles, had
closely approximating growths upon them, while under the thick
epidermis of the palms of the hands were blisters. Itching was intense.
The patient became emaciated and died thirteen days after his admission
into the hospital. A histologic examination showed the sarcomatous
nature of the various growths. The disease differed from
"button-scurvy." Mycosis fungoides approximates, clinically and
histologically, granulomata and sarcomata.
Morris described an interesting case of universal dermatitis, probably
a rare variety of mycosis fungoides. The patient had for many years a
disease which had first appeared on the arms and legs, and which was
usually regarded by the physicians who saw the case as eczema. At times
the disease would entirely disappear, but it relapsed, especially
during visits to India. At the time the patient came under the care of
Morris, his general health seemed unaffected. The skin of the whole
body, except the face, the scalp, and the front of the chest, was of a
mahogany color. The skin of the lips was so thickened that it could not
be pinched into folds, and was of a mottled appearance, due to
hemorrhagic spots. All over the thickened and reddened surface were
scattered crops of vesicles and boils. The nails were deformed, and the
toes beyond the nails were tense with a serous accumulation. The glands
in the right axilla and the groin were much enlarged. The hair on the
pubes had disappeared. The abdomen was in a condition similar to that
upon the limbs, but less in degree. The front of the chest below the
nipples was covered with dark papules the size of a pin's head. The
back, the buttocks, the face, and the scalp presented similar lesions.
The most striking lesions were three ulcers--one on the back of the
right hand, one on the right temple, and the other on the left cheek.
The largest was the size of a florin, and had elevated borders,
somewhat infiltrated; they were covered with a brown, dry scab. The
patient suffered from itching at night so that he could not sleep. He
was kept under observation, and in spite of treatment the malady
advanced in a periodic manner, each exacerbation being preceded by a
feeling of tension in the parts, after which a crop of vesicles would
appear. Sometimes, especially on the feet, bullae formed. The patient
finally left the hospital and died of an intercurrent attack of
pneumonia. A microscopic examination revealed a condition which might
be found with a number of the chronic affections of the skin, but, in
addition, there were certain cell-inclusions which were thought to
represent psorosperms. Morris thought this case corresponded more to
mycosis fungoides than any other malady.
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