CASE 4.—Mr. M——, aged 54 years, a gentleman in good circumstances, was
brought to me on June 2nd, 1903, by Dr. Lovell. All his family were
long-lived. His grandfather was killed by an accident aged 93 years, but
his father died of cardiac disease, aged 67 years. The disease the
patient suffered from commenced early in April, _i.e._ two months before
I saw him, on the right leg, and by June had extended all over the lower
limbs and on the trunk, nearly all over the back, but there was scarcely
any on the front. On the forearms, the patches were more on the extensor
than the flexor surface. The eruption consisted of irregular, pale,
erythematous patches from a square inch to the palm in size, with
distinct infiltration in most of them. On the back, they were arranged
symmetrically in the direction of the ribs, _i.e._ sloping downwards and
forwards from back to front. In the early stage, on the back, they could
be traced to commence as minute papules at the hair-follicles, and
gradually the intervals between were filled up until infiltrations with
a uniform surface were formed. Some itched, but none severely, and many
did not itch at all.
Salicin 15 grains three times a day, with 5 minims of tincture of nux
vomica, was prescribed. On June 23rd I saw him again, and there was then
distinctly less thickening on the thighs and legs and the eruption was
somewhat less bright in some parts. The longitudinal patches over the
scapula were still thickened, but there was less infiltration in the
patches on the upper limbs and on the forearms they were yellower.
In response to my inquiry Dr. Lovell wrote me on November 29th, 1904,
that he saw the patient on July 19th, 1903, and the eruption appeared to
be gradually fading away. He next saw him for a sore throat in January,
1904, and the patient told him that the skin affection had gradually
left him. He had had no other treatment than taking the salicin which I
prescribed. This case is the most satisfactory and rapid in its
involution under treatment, as it was also the most rapid in its
evolution, and came earlier under my observation than any of the others.
* * * * *
CASE 5.—Dr. D——, aged 53 years. In 1876, while a house-surgeon, he first
noticed a patch on one calf; since then the patches have gradually
increased in number, and some of them in size. Chrysarobin kills them
down for a time, but they re-form in the same place. In his family
history a sister died of Addison’s disease, and one daughter is slightly
phthisical. His own health is good and he is well nourished.
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