An attack of eczema is usually described as acute or chronic, but the only distinction lies in the greater or less intensity of the inflammation at the time of description: it has nothing to do with the length of time that the disease has lasted. The illness usually begins with a feeling of itching and burning at the site of the lesion. The skin becomes covered with an erythematous blush, on which numerous tiny vesicles form. Swelling, heat, redness and tension are all present. The vesicles grow larger, run together, and either burst or are broken by the patient's scratching, a clear fluid exuding which stiffens linen. The discharge does not dry up at once, but continues to exude--hence the name of "weeping eczema" when this is a prominent symptom. In mild cases the symptoms begin to subside in a few days, the exudation growing less and scales and scabs forming, under which new skin is formed. But where the attack is more acute fresh crops of vesicles spring up and the process repeats itself. In some cases papules are the predominant lesions, but in others, especially when the face is attacked, the erythematous condition is more marked. A severe attack of eczema is usually accompanied by some slight constitutional disturbance, but the general health seldom suffers appreciably, unless, as occasionally, the itching is so bad as to make sleep impossible. The irritation and local heat may be out of all proportion to visible changes in the skin, and in neurotic patients the nervous excitement may be extreme. The attack may centre itself on any part of the body, but there are certain places where it more usually begins, such as the bends of the elbows, the backs of the knees and the groins; the groove behind the ears, the scalp, the palms or the soles, and the breasts of women. According to its position the form of the eczema is somewhat modified. On the front of the legs and arms, from the uniform redness it exhibits in these positions, it is known as eczema rubrum. On the scalp it is generally of the seborrhoeic type, and in children, especially when pediculi are present, it will become pustular from microbic infection. On the palms and soles it brings about a thickening of the epidermis which leads to the formation of cracks, and is hence called eczema rimosum.