A treatise on diseases of the skin with special reference to their diagnosis and treatment : including an analysis of 12,000 consecutive cases / Thomas McCall Anderson.

  • Anderson, McCall, 1836-1908.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on diseases of the skin with special reference to their diagnosis and treatment : including an analysis of 12,000 consecutive cases / Thomas McCall Anderson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    3. Tubercula, or tubercles, are simply giant papules, varying in size from that of a pea to a marble. They vary, too, very much in structure. Thus, in fibroma molluscum there is a circumscribed hypertrophy of the corium—especially of that part which forms the sac of the hair—which pushes the more superficial parts before it; in syphilis and leprosy, on the other hand, there is a copious development of cells in the corium, which, according to Virchow, are connective- tissue corpuscles arrested in their growth, and which do not undergo further development, but are apt to degenerate and lead to ulcer- ation or atrophy. In epithelioma, on the other hand, it is the epidermis, and not the corium, which is specially involved. 4. Phymata, or tumours, are larger than tubercles, being at least the size of walnuts, and are exceedingly varied in structure; some- times they are sessile, occasionally they are pedunculated; some- times they are very prominent, sometimes deeply set in the substance of the skin, as in the case of the little tumours of erythema nodosum. 5. Pomphi, or wheals.—These are circumscribed elevations, most frequently oval or rounded in form, or assuming the shape of segments of circles (hence the name), and very evanescent, appearing and disappearing with remarkable rapidity: they are the result of an acute inflammatory oedema having its seat in the papillary layer of the corium. The exudation is thinner and more serous than in the case of most inflammatory lesions; hence the rash is very fleeting, the vessels recovering their tonicity and the exudation being absorbed. In children the inflammation is often less fleeting, the exudation being accompanied by the deposit of lymph, and the eruption being more or less papular (lichen urticatus). When the wheal is typical, the circumference is red and the centre pale, because the exudation in the central part compresses the blood-vessels, and drives the blood to the periphery. There are some who hold that spasm of the muscular fibres of the skin has a good deal to do with the appearance of pomphi; while Liveing seems to be of opinion that the condition is the result of a spasmodic contraction of the muscular coat of the vessels. We have familiar illustrations of pomphi in the result of the sting of the common nettle, and in the disease which takes its name from it—viz., urticaria, or nettle-rash. 6. Vesiculse, or vesicles.—These are little elevations above the level of the skin, about the size of papules, but not solid like them, being due to the accumulation of clear or turbid serous fluid on the surface of the corium, or between the horny and mucous layers of the epidermis, or, more rarely, in the lymphatics of the corium (lymph-