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THE

COLLEGE AND CLINICAL RECORD.

A

MONTHLY JOURNAL OF PRACTICAL MEDICINE.

EDITED BY

RICHARD J. DUNGLISON, A. M., M. D.

VOLUME XVI.

PHILADELPHIA.

1895.

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I

Vol. XVI. No. 1.

1.} THE COLLEGE AND CLINICAL RECORD. January, 1895. Original Articles.

DEC15 1888 the father of one boy and a girl, aged

respectively 21 and 23 years, and thought A CASE OF TUBERCULAR SYNLABRA Been them for fifteen or sixteen years, they

meg, vere/in good healthalthough ODERM.

living in Yorkshire, England, and from whom BY J. ABBOTT CANTRELL, M. D.,

he had separated.

The lesion to which our attention was called Professor of Diseases of the Skin in the Philadelphia Polyclinic and College for Graduates in Medicine; Dermatologist to the was situated

upon

the
upper

and outer border Philadelphia Hospital, etc.

of the middle finger of the right hand. On As the records of many interesting cases close inspection it was noted to be irregular are not seen other than by the assistants in in outline, being about three-quarters of an the several departments, I take great pleasure inch in diameter, and showing a pinkish-red in giving the account of one that was more color when the hand was held above the head, an usually interesting.

but on allowing the hand to hang at the The case in question resembled both the side for a few moments the color gradually eruptions due to syphilis and tuberculosis, and changed to a bluish tint, with the excepso much that it took some time before a cor- tion of a small area on the summit of the rect diagnosis was made.

lesion, which became shiny and looked as if The patient, a male, 47 years of age, shoe- it were moist, but upon passing the finger maker, presented himself at my service at the over the part this condition was not noticePhiladelphia Polyclinic on August 8th, last, able. complaining of an eruption upon the middle The lesion was raised about three-sixfinger of the right hand, stating that it was of teenths of an inch above the surrounding ten weeks' duration.

healthy skin. As above stated, it gave us The family history was recorded as fol- a very irregular outline, showing indentations lows: Father living, in good health at the age here and there, and strongly resembled the of 88 years; mother died of so-called gallop- appearance of a circular saw. ing phthisis at the age of 28 or 29 years. Be- The part to the touch appeared to be very sides himself there were three members of his much thickened, although not infiltrated, and immediate family living and in good health, apparently affected the subcutaneous as well one only having died, a sister, one year ago, as the superficial layers. There was no ulcerof inflammation of the intestines at the age ation, and the condition did not give the of 52 years.

patient discomfort, with the exception that The maternal grandparents lived to be quite the eruption interfered with his work, being aged, two of his maternal aunts being alive in the position where the thread would irriand over 80 years of age, while two maternal tate it occasionally. uncles were also living, although at an age Without reference to the points of differyounger than the patient. The notes fail to ential diagnosis in this report, I feel that the give the paternal history, probably on account record of the treatment employed and the of want of knowledge of the patient.

result obtained from its use will be sufficient According to the personal and family his- to give you the correct diagnosis. tory of the patient, he had smallpox at the On the date of his visit he was ordered to age of 17, which marks he shows at the date take 15 grains of potassium iodide three of this examination. He contracted an initial time a day, and to report some days later. lesion of syphilis at the age of 32, and again He appeared at the clinic on the following six months before his visit to my clinic. dates: September ist, and occasionally until

He stated that he never had a generalized the 26th of that month, when he was diseruption follow. Otherwise he has never had charged, the eruption having disappeared any sickness.

entirely.

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