Chapter VIII: Part 8

Actinomycosis of the skin is an affection due to the ray fungus, and characterized by a sluggish, red, nodular, or lumpy infiltration, usually with a tendency to break down and form sinuses. The affection may involve almost any part, but its most common site is about the jaw, neck, and face. As a rule, the first evidence is a hard subcutaneous swelling or infiltration, which may increase slightly or considerably. The overlying skin gradually becomes of a sluggish or dark-red color. Softening ensues, and the diseased area breaks down at one or more points, from which there oozes a discharge of a sero-purulent, purulent, or sanguinolent character. In this discharge can be usually noted minute, friable, yellowish or yellowish-gray bodies representing conglomerate collections of the causative fungus.

The course of the malady is commonly slow and insidious. Unless systemic pyemic infection occurs or the fungus elements find their way to the deeper organs or structures the general health remains apparently undisturbed.

#What is the treatment?#

The administration of moderate to large doses of potassium iodide, conjointly with curetting or excision of the diseased mass. Local applications of iodine solution can also be tried.

#Blastomycetic Dermatitis.#

#What do you understand by blastomycetic dermatitis?#

Blastomycetic dermatitis is a rare disease beginning usually as a small papule or nodule, enlarging slowly, breaking down and developing into a verrucous or papillomatous-looking area, similar in appearance to tuberculosis cutis verrucosa. A muco-purulent or purulent secretion can visually be pressed out from between the papillomatous elevations. It may also present the appearance of a serpiginous lupus vulgaris or syphiloderm. As a rule it is slow in its course. Furuncular or abscess-like formations may develop, usually from secondary infection. The disease is due to the invasion of the cutaneous tissues by the blastomyces.

Treatment consists in administration of moderate to large doses of potassium iodide, and in the employment of antiseptic and parasiticide applications; usually, however, radical treatment, such as employed in lupus vulgaris, may be necessary.

#Scabies.#
(_Synonym:_ The Itch.)

#What is scabies?#

Scabies, or itch, is a contagious animal-parasitic disease characterized by a multiform eruption of a somewhat peculiar distribution, attended by intense itching.

#Describe the symptoms of scabies.#

The penetration and presence of the parasites within the cutaneous structures besides often giving rise to several or more complete or imperfectly formed _burrows_, excite varying degrees of irritation, and in consequence the formation of vesicles, papules and pustules, accompanied with more or less intense itching. Secondarily, crusting, and at times a mild or severe grade of dermatitis, may be brought about. The parasite seeks preferably tender and protected situations, as between the fingers, on the wrists, especially the flexor surface, in the folds of the axilla, on the abdomen, about the anal fissure, about the genitalia, and in females also about the nipples, and hence the eruption is most abundant about these regions. The inside of the thighs and the feet are also attacked, as, indeed, may be almost every portion of the body. The scalp and face are not involved; exceptionally, however, these parts are invaded in infants and young children.

#Is the grade of cutaneous irritation the same in all cases of scabies?#

No; in those of great cutaneous irritability, especially in children, the skin being more tender, the type of the eruption is usually much more inflammatory. In those predisposed a true eczema may arise, and then, in addition to the characteristic lesions of scabies, eczematous symptoms are superadded; in long-persistent cases, indeed, the burrows and other consequent lesions may be more or less completely masked by the eczematous inflammation, and the true nature of the disease be greatly obscured.

#What do you mean by burrows?#

Burrows, or _cuniculi_, are tortuous, straight or zigzag, dotted, slightly elevated, dark-gray or blackish thread-like linear formations, varying in length from an eighth to a half an inch.

#How is a burrow formed?#

By the impregnated female parasite, which penetrates the epidermis obliquely to the rete, depositing as it goes along ten or fifteen ova, forming a minute passage or burrow.

#Upon what parts are burrows most commonly to be found?#

In the interdigital spaces, on the flexor surface of the wrists, about the mammae in the female, and on the shaft of the penis in the male.

#Are burrows usually present in numbers?#

No. Several may be found in a single case, but they are rarely numerous, as the irritation caused by the penetration of the parasites leads either to violent scratching and their destruction, or gives rise to the formation of vesicles and pustules, and consequently their formation is prevented.

#What course does scabies pursue?#

Chronic and progressive, showing no tendency to spontaneous disappearance.

#To what is scabies due?#

To the invasion of the cutaneous structures by an animal parasite, the sarcoptes scabiei (_acarus scabiei_). The male mite is never found in the skin and apparently takes no direct part in the production of the symptoms.

The disease is contagious to a marked degree, and is most commonly contracted by sleeping with those affected, or by occupying a bed in which an affected person has slept. It occurs, for obvious reasons, usually among the poor, although it is now quite frequently met with among the better classes.

#State the diagnostic features of scabies.#

The burrows, the peculiar distribution and the multiformity of the eruption, the progressive development, and usually a history of contagion.

#How do vesicular and pustular eczema differ from scabies?#

Eczema is usually limited in extent, or irregularly distributed, is distinctly patchy, with often the formation of large diffused areas; it is variable in its clinical behavior, better and worse from time to time, and differs, moreover, in the absence of burrows and of a history of contagion.

#How does pediculosis corporis differ from scabies?#

In the distribution of the eruption. The pediculi live in the clothing and go to the skin solely for nourishment, and hence the eruption in that condition is upon covered parts, especially those parts with which the clothing lies closely in contact, as around the neck, across the upper part of the back, about the waist and down the outside of the thighs; _the hands are free_.

#State the prognosis of scabies.#

It is favorable. The disease is readily cured, and, as soon as the parasites and their ova are destroyed, the itching and the secondary symptoms, as a rule, rapidly disappear.

#How is scabies treated?#

Treatment is entirely external, and consists of a preliminary soap-and-hot-water bath, an application, twice daily for three days, of a remedy destructive to the parasites and ova, and finally another bath.

Inquiry as to others of the family should be made, and, if affected, treated at the same time. The wearing apparel should be looked after--boiled, baked, or sulphur-fumigated.

#What remedial applications are employed in scabies?#

Sulphur, balsam of Peru, styrax, and [beta]-naphthol, singly or severally combined. In children, or in those of sensitive skin, the following:--

[Rx] Sulphur. praecip., .................... [dram]iv
Balsam. Peruv., ...................... [dram]ij
Adipis,
Petrolati, ......... [=a][=a] ........ [Oz]iss. M.

And in adults, or those of non-irritable skin:--

[Rx] Sulphur, praecip., .................... [Oz]j
Balsam. Peruv., ...................... [Oz]ss
[beta]-Naphthol, ..................... [dram]ij
Adipis,
Petrolati, ... [=a][=a] ... q.s. ad .. [Oz]iv. M.

Styrax is a remedy of value and is commonly employed as an ointment in the strength of one part to two or three parts of lard.

#Is one such course of treatment sufficient to bring about a cure?#

Yes, in ordinary cases, if the applications have been carefully and thoroughly made; exceptionally, however, some parasites and ova escape destruction, and consequently itching will again begin to show itself at the end of a week or ten days, and a repetition of the treatment become necessary.

#Does the secondary dermatitis which is always present in severe cases require treatment?#

Only when it is unusually persistent or severe; in such cases the various soothing applications, lotions or ointments employed in acute eczema are to be prescribed.

#Is a dermatitis due to too active and prolonged treatment ever mistaken for persistence of the scabies?#

Yes.

#Pediculosis.#
(_Synonyms:_ Phtheiriasis; Lousiness.)

#Define pediculosis.#

Pediculosis is a term applied to that condition of local or general cutaneous irritation due to the presence of the animal parasite, the pediculus, or louse.

#Name the several varieties met with.#

Three varieties are presented, named according to the parts involved, pediculosis capitis, pediculosis corporis, and pediculosis pubis; the parasite in each being a distinct species of pediculus.

#Pediculosis Capitis.#

#Describe the symptoms of pediculosis capitis.#

Pediculosis capitis (_pediculosis capillitii_), due to the presence of the pediculus capitis, occurs much more frequently in children than in adults. It is characterized by marked itching, and the formation of various inflammatory lesions, such as papules, pustules and excoriations--resulting from the irritation produced by the parasites and from the scratching to which the intense pruritus gives rise. In fact, an eczematous eruption of the pustular type soon results, attended with more or less crust formation. In consequence of the cutaneous irritation the neighboring lymphatic glands may become inflamed and swollen, and in rare cases suppurate. The occipital region is the part which is usually most profusely infested, more especially in young girls and women. In those of delicate skin, especially in children, scattered papules, vesico-papules, pustules, and excoriations may often be seen upon the forehead and neck. In some instances, however, especially in boys, there may be many pediculi present, with but little cutaneous disturbance, the itching being the sole symptom.

In addition to the pediculi, which, as a rule, may be readily found, their _ova_, or _nits_, are always to be seen upon the shaft of the hairs, quite firmly attached.

#Describe the appearance of the ova.#

They are dirty-white or grayish looking, minute, pear-shaped bodies, visible to the naked eye, and fastened upon the shaft of the hairs with the small end toward the root.

#Is there any difficulty in the diagnosis of pediculosis capitis?#

No. The diagnosis is readily made, as the pediculi are usually to be found without difficulty, and even when they exist in small numbers and are not readily discovered, _the presence of the ova_ will indicate the nature of the affection.

Pustular eruptions upon the scalp, especially posteriorly, should always arouse a suspicion of pediculosis. The possibility of the pediculosis being secondary to eczema must not be forgotten.

#What is the treatment of pediculosis capitis?#

Treatment consists in the application of some remedy destructive to the pediculi and their ova. Crude petroleum is effective, one or two thorough applications over night being usually sufficient; in order to lessen its inflammability, and also to mask its somewhat disagreeable odor, it may be mixed with an equal part of olive oil and a small quantity of balsam of Peru added.

Tincture of cocculus indicus, pure or diluted, may also be applied with good results.

When the parts are markedly eczematous, an ointment of ammoniated mercury or [beta]-naphthol, thirty to sixty grains to the ounce may be used.

Daily shampooing with soap and water, and the twice daily application of a five per cent. carbolic acid lotion, together with the use of a fine-toothed comb, is a safe and efficient method for dispensary practice; as it is, indeed, for any class of patients.

#How are the ova or their shells to be removed from the hair?#

By the frequent use of acid or alkaline lotions, such as dilute acetic acid and vinegar, or solutions of sodium carbonate and borax.

#Pediculosis Corporis.#

#Describe the symptoms of pediculosis corporis.#

Pediculosis corporis is dependent upon the presence of the pediculus corporis (_pediculus vestimenti_), a larger variety than that infesting the scalp. It is characterized by more or less general itching, together with various inflammatory lesions and excoriations. As the parasites are to be found chiefly in the folds and seams of the clothing, visiting the skin for the purpose of feeding, the various symptoms--the minute hemorrhagic puncta showing the points at which they have been sucking, and the consequent papules, pustules and excoriations--are, therefore, to be found most abundantly on those parts with which the clothing comes closely in contact, as, for instance, around the neck, across the shoulders, around the waist, and down the outside of the thighs. It is uncommon in children.

#State the diagnostic characters of pediculosis corporis.#

The presence of the minute hemorrhagic puncta, the multiform character and peculiar distribution of the eruption. Careful search will almost invariably disclose one or more pediculi.

#What is the treatment of pediculosis corporis?#

The clothing and bed-coverings are to be thoroughly baked or boiled, the pediculi and their ova being in this manner destroyed; a thymol or carbolized boric-acid lotion may be used to relieve the cutaneous irritation.

When attention to the wearing apparel is not immediately practicable, ointments of sulphur and staphisagria, and lotions of carbolic acid, may be advised as temporary measures. The wearing of a bag of loosely woven texture containing some lump sulphur next to the skin is useful in such cases; at the temperature of the body the sulphur undergoes slow oxidation. In hairy individuals the malady is often persistent, due to the fact that ova have become attached to the hair and a new progeny soon hatched out. Continued treatment over a few weeks will usually suffice to rid the patient of their presence.

#Pediculosis Pubis.#

#Describe the symptoms of pediculosis pubis.#

Pediculosis pubis is a condition due to the presence of the pediculus pubis, or crab-louse. It is characterized by more or less itching about the genitalia, together with papules, excoriations, and other inflammatory lesions. The amount of irritation varies; it may be slight, or, on the other hand, severe. The parasite, which is the smallest of the three varieties, may be discovered upon close examination seated near the roots of the hairs, clutching the hair, with its head downward and buried in the follicle. The ova may be seen attached to the hair-shafts.

It infests adults chiefly, being in many instances probably contracted through sexual intercourse.

#Is the pediculus pubis found upon any other part of the body?#

Yes. Although its favorite habitat is the region of the pubes, it may, in exceptional instances, also infest the axillae, the sternal region of the male, the beard, eyebrows, and even the eyelashes.

#State the diagnostic characters of pediculosis pubis.#

The region involved, itching, variable amount of irritation, and, above all, the presence of the pediculi and their ova.

#Name several applications prescribed for pediculosis pubis.#

A lotion of corrosive sublimate, one to four grains to the ounce; infusion of tobacco; a ten to twenty per cent. ointment of oleate of mercury; ammoniated mercury ointment, and a five to ten per cent. [beta]-naphthol ointment. Repeated washings with vinegar or dilute acetic acid, or with alkaline lotions, will free the hairs of the ova.

#Cysticercus Cellulosae.#

#Describe the cutaneous disturbance produced by the cysticercus cellulosae.#

The presence of cysticerci in the skin and subcutaneous tissue gives rise to pea to hazelnut-sized, rounded, firm, movable tumors which, when developed, may remain unchanged for months. The parasites are disclosed by microscopic examination.

Most of the cases have been observed in Germany.

#Filaria Medinensis.#
(_Synonym:_ Guinea-worm.)

#State the character of the lesions produced by the filaria medinensis.#

The young microscopic worm penetrates the skin or deeper tissue, where it grows gradually, finally reaching several inches or more in length and about a half-line in thickness; inflammation is excited and a tumor-like swelling makes its appearance, which, sooner or later, breaks, disclosing the worm. It may also present a cord-like appearance. It is rarely met with outside of tropical countries.

Treatment consists in gradual extraction, or in the injection of a corrosive sublimate solution (1:1000) into the forming tumor. Asafetida internally has been found to be curative, the parasite being destroyed and subsequently absorbed or discharged.

#Ixodes.#
(_Synonym:_ Wood-tick.)

#State the character of the cutaneous disturbance produced by the ixodes.#

The tick sticks its proboscis into the skin and sucks blood until it is several times its natural size, and then falls off; an urticarial lesion results. If caught in the act the animal should not be forcibly extracted, as its proboscis may be thus broken off and remain in the skin, and give rise to pain and inflammation. It may be made to relinquish its hold by placing on it a drop of an essential oil.

A thymol or carbolized boric-acid lotion will relieve the irritation.

#Leptus.#
(_Synonym:_ Harvest-mite.)

#State the characters of the lesion produced by the leptus.#

This minute brick-red mite buries itself in the skin, especially about the ankles and feet, giving rise to papules, vesicles and pustules.

Treatment consists of the use of a mild sulphur ointment or of a carbolic-acid lotion.

#[OE]strus.#
(_Synonym:_ Gad, or Bot-fly.)

#Describe the cutaneous disturbance produced by the [oe]strus.#

The ova are deposited in the skin, develop and give rise to the formation of furuncle-like tumors with central aperture, through which a sanious discharge exudes; or as the result of the burrowing of the larvae, irregular serpiginous lines or wheals are produced.

It is chiefly met with in Central and South America.

_Larva migrant_, or _creeping disease_, is doubtless in this same class. It is characterized by a thread-like linear formation of an erythematous, erythemato-papular, or vesicular nature that gradually extends, the older part disappearing; considerable surface may be covered before the parasite disappears or dies. The treatment consists in endeavoring to destroy the organism by means of excision or caustic applications at the point of its suspected site which is just ahead of the extending line.

#Pulex Penetrans.#
(_Synonyms:_ Sand Flea; Jigger.)

#Describe the cutaneous disturbance produced by the pulex penetrans.#

This microscopic animal penetrates the skin, especially about the toes, producing an inflammatory swelling, vesicle or pustule, or even ulceration. It is met with in warm and tropical countries.

Treatment consists in extraction. Essential oils are used as a preventive. A carbolic-acid or alkaline lotion relieves irritation.

#Cimex Lectularius.#
(_Synonym:_ Bed-bug.)

#Describe the characters of a bed-bug bite.#

An inflammatory papule or wheal-like lesion results, somewhat hemorrhagic; the purpuric or hemorrhagic point or spot remains after the swelling subsides, but finally, in the course of several days or a few weeks, disappears.

Treatment consists in the application of alkaline or acid lotions.

#Culex.#
(_Synonym:_ Gnat; Mosquito.)

#Describe the cutaneous disturbance produced by the culex.#

It consists of an erythematous spot or a wheal-like lesion.

Alkaline or acid lotions usually give relief.

#Pulex Irritans.#
(_Synonym:_ Common Flea.)

#Describe the cutaneous disturbance produced by the pulex irritans.#

It consists of an erythematous spot with a minute central hemorrhagic point. In irritable skin, a wheal-like lesion may result.

Treatment consists of applications of camphor or ammonia-water; carbolic acid and thymol lotions are also useful.

RELATIVE FREQUENCY OF THE VARIOUS DISEASES OF SKIN AS SHOWN BY THE STATISTICS (123,746 CASES) OF THE AMERICAN DERMATOLOGICAL ASSOCIATION FOR TEN YEARS, 1878-87.

-------------------------+-------+-------+
CLASSIFICATION OF | No. | % |
DISEASES. | Cases | Cases |
-------------------------+-------+-------+
Class I. Disorders of the| | |
Glands. | | |
1. OF THE SWEAT GLANDS.| | |
Hyperidrosis | 328 | .265 |
Sudamen | 268 | .216 |
Anidrosis | 11 | .009 |
Bromidrosis | 112 | .090 |
Chromidrosis | 7 | .005 |
Uridrosis | ... | .... |
2. OF THE SEBACEOUS | | |
GLANDS | 238 | .193 |
Seborrh[oe]a: | 1812 | 1.47 |
a. oleosa | 367 | .296 |
b. sicca | 395 | .319 |
Comedo | 1225 | .989 |
Cyst: | 6 | .004 |
a. Milium | 225 | .183 |
b. Steatoma | 151 | .122 |
Asteatosis | 8 | .006 |
| | |
Class II. Inflammations. | | |
Exanthemata | 1770 | 1.43 |
Erythema simplex | 1064 | .859 |
Erythema multiforme: | 915 | .730 |
a. papulosum | 325 | .262 |
b. bullosum | 37 | .029 |
c. nodosum | 82 | .066 |
Urticaria | 2994 | 2.47 |
pigmentosa | 1 | .0008|
[E]Dermatitis: | 1720 | 1.39 |
a. traumatica | 468 | .378 |
b. venenata | 616 | .498 |
c. calorica | 224 | .187 |
d. medicamentosa | 108 | .087 |
e. gangraenosa | 8 | .006 |
Erysipelas | 1026 | .829 |
Furunculus | 2129 | 1.72 |
Anthrax | 252 | .203 |
Phlegmona diffusa | 265 | .215 |
Pustula maligna | 197 | .159 |
Herpes simplex | 2057 | 1.66 |
Herpes zoster | 1428 | 1.15 |
Dermatitis | | |
herpetiformis | 41 | .033 |
Psoriasis | 4131 | 3.34 |
Pityriasis maculuta | | |
et circinata | 71 | .057 |
Dermatitis | | |
exfoliativa | 16 | .012 |
Pityriasis rubra | 44 | .032 |
Lichen: | 144 | .116 |
a. planus | 154 | .124 |
b. ruber | 27 | .021 |
Eczema: | 37661 |30.43 |
a. erythematosum | .... | .... |
b. papulosum | .... | .... |
c. vesiculosum | .... | .... |
d. madidans | .... | .... |
e. pustulosum | .... | .... |
f. rubrum | .... | .... |
g. squamosum | .... | .... |
Prurigo | 34 | .027 |
Acne | 9077 | 7.34 |
Acne rosacea | 398 | .321 |
Sycosis | 227 | .185 |
Impetigo | 1769 | 1.43 |
Impetigo contagiosa | 600 | .485 |
Impetigo | | |
herpetiformis | 10 | .009 |
Ecthyma | 726 | .587 |
Pemphigus | 183 | .148 |
Ulcers | 3021 | 2.44 |
| | |
Class III. Hemorrhages. | | |
Purpura: | 341 | .275 |
a. simplex | 181 | .145 |
b. haemorrhagica | 49 | .039 |
| | |
Class IV. Hypertrophies. | | |
1. OF PIGMENT. | | |
Lentigo | 127 | .103 |
Chloasma | 560 | .452 |
2. OF EPIDERMAL AND | | |
PAPILLARY LAYERS. | | |
Keratosis: | 94 | .076 |
a. pilaris | 103 | .083 |
b. senilis | 68 | .055 |
Molluscum epitheliale| 172 | .139 |
Callositas | 110 | .090 |
Clavus | 84 | .068 |
Cornu cutaneum | 42 | .034 |
Verruca | 1252 | 1.09 |
Verruca necrogenica | 2 | .001 |
Naevus pigmentosus | 88 | .064 |
Xerosis | 100 | .080 |
Ichthyosis | 309 | .249 |
Onychauxis | 70 | .056 |
Hypertrichosis | 515 | .416 |
3. OF CONNECTIVE | | |
TISSUE. | | |
Sclerema neonatorum | .... | .... |
Scleroderma | 38 | 0.030 |
Morph[oe]a | 39 | 0.031 |
Elephantiasis | 57 | 0.046 |
Rosacea: | 785 | 0.634 |
a. erythematosa | 381 | 0.308 |
b. hypertrophica | 58 | 0.047 |
Framb[oe]sia | 22 | 0.018 |
| | |
Class V. Atrophies. | | |
1. OF PIGMENT. | | |
Leucoderma | 77 | 0.062 |
Albinismus | 9 | 0.008 |
Vitiligo | 191 | 0.155 |
Canities | 43 | 0.035 |
2. OF HAIR. | | |
Alopecia | 926 | 0.749 |
Alopecia furfuracea | 830 | 0.670 |
Alopecia areata | 794 | 0.641 |
Atrophia pilorum | | |
propria | 23 | 0.019 |
Trichorexis nodosa | 3 | 0.002 |
3. OF NAIL | 26 | 0.021 |
Atrophia unguis | 19 | 0.015 |
4. OF CUTIS | 6 | 0.005 |
Atrophia senilis | 15 | 0.013 |
Atrophia maculosa et | | |
striata | 23 | 0.019 |
| | |
Class VI. New Growths. | | |
1. OF CONNECTIVE | | |
TISSUE. | 1 | 0.0008|
Keloid | 152 | 0.124 |
Cicatrix | 89 | 0.065 |
Fibroma | 93 | 0.075 |
Neuroma | 11 | 0.009 |
Xanthoma | 69 | 0.056 |
2. OF MUSCULAR TISSUE. | | |
Myoma | 1 | 0.0008|
3. OF VESSELS. | | |
Angioma | 462 | 0.373 |
Angioma pigmentosum | | |
et atrophicum | 13 | 0.010 |
Angioma cavernosum | 22 | 0.018 |
Lymphangioma | 16 | .012 |
4. Mycosis fongoide | 1 | .0008|
Rhinoscleroma | 3 | .002 |
Lupus erythematosus | 477 | .385 |
Lupus vulgaris | 536 | .433 |
Scrofuloderma | 663 | .536 |
Syphiloderma: | 13888 |11.22 |
a. erythematosum | .... | .... |
b. papulosum | .... | .... |
c. pustulosum | .... | .... |
d. tuberculosum | .... | .... |
e. gummatosum | .... | .... |
Lepra: | 24 | .020 |
a. tuberosa | 7 | .005 |
b. maculosa | 4 | .003 |
c. anaesthetica | 6 | .004 |
Carcinoma | 1068 | .863 |
Sarcoma | 55 | .044 |
| | |
Class VII. Neuroses. | | |
Hyperaesthesia: | 4 | .003 |
a. Pruritus | 2716 | 2.12 |
b. Dermatalgia | 11 | .009 |
Anaesthesia | 22 | .018 |
| | |
Class VIII. Parasitic | | |
Affections. | | |
1. VEGETABLE. | | |
Tinea favosa | 354 | .286 |
Tinea trichophytina: | 2289 | 1.85 |
a. circinata | 705 | .569 |
b. tonsurans | 675 | .545 |
c. sycosis | 365 | .295 |
Tinea versicolor | 1263 | 1.02 |
2. ANIMAL. | | |
Scabies | 3192 | 2.58 |
Pediculosis | | |
capillitii | 2579 | 2.09 |
Pediculosis corporis | 1704 | 1.38 |
Pediculosis pubis | 436 | .352 |
-------------------------+-------+-------+
Total 123746

[Footnote E: Indicating affections of this class not properly included
under other titles.]

#INDEX.#

Acarus folliculorum, 40
scabiei, 269

Achorion Schoenleinii, 249

Acne, 115-126
artificialis, 120
atrophica, 120
cachecticorum, 120
frontalis, 129
hypertrophica, 120
indurata, 120
keloid, 135
lupoid, 129
necrotica, 129
papulosa, 120
punctata, 120
pustulosa, 120
rodens, 129
rosacea, 126-129, 198
sebacea, 33
tar, 120
urticata, 130
varioliformis, 129
vulgaris, 119

Acnitis, 130

Actinomycosis, 266

Addison's disease, pigmentation of the skin in, 149
keloid, 172

Ainhum, 212

Albinismus, 177

Albinos, 177

Alopecia, 181-183
areata, 183-186
circumscripta, 183
congenital, 181
furfuracea, 181
premature, 181
senile, 181

Anaesthesia, 244

Anatomy of the skin, 17-21, 28

Angioma, 196, 197
cavernosum, 197
pigmentosum et atrophicum, 190
simplex, 196

Angiomyoma, 196

Angioneurotic [oe]dema, 54

Anidrosis, 31

Anthrax, 70, 72

Antipruritic applications, 246

Antipyrin, eruptions from, 61

Area Celsi, 183

Argyria, 150

Arsenic, eruptions from, 61

Artificial eruptions (feigned eruptions), 64

Atrophia cutis, 189, 190
pilorum propria, 187
unguis, 188, 189

Atrophic lines and spots, 190

Atrophies, 177-190

Atrophoderma, 189
neuriticum, 189

Atrophy of the hair, 187
of the nails, 188
of the skin, 189
general idiopathic, 189
senile, 190

Atropia, eruptions from, 61

Autographism, 52

Baldness, 181

Barbadoes leg, 174

Barbers' itch, 255

Bath-pruritis, 245

Bed-bug, 278

Bed-sores, 58

Belladonna, eruptions from, 61

Blackheads, 38-41

Blanching of the hair, 180

Blastomycetic dermatitis, 266

Blebs, 23

Blood-vessels, 19

Boil, 68

Bot-fly, 278

Bromides, eruptions from, 61

Bromidrosis, 32

Bullae, 23

Burns, 58

Burrows, 268

Calculi, cutaneous, 42

Callositas, 155, 156

Callosity, 155

Callous, 155

Callus, 155

Cancer, epithelial, 236
skin, 236

Canities, 180
prematura, 180
senilis, 180

Carbuncle, 70

Carbunculus, 70-72

Carcinoma epitheliale, 236

Carrion's disease, 73

Chafing, 45

Chapping, 106

Charbon, 72

Cheiro-pompholyx, 76

Cheloid, 191

Chloasma, 149-151
uterinum, 149

Chloral, eruptions from, 62

Chromidrosis, 32
red, 33

Chromophytosis, 262

Chrysarobin, 93

Chrysophanic acid (chrysarobin), 93

Cicatrices, 24

Cimex lectularius, 278

Clavus, 156, 157

Comedo, 38-41
extractor, 40

Condyloma, flat (or broad), 217
pointed, 161

Configuration, 24

Conglomerate pustular folliculitis, 252

Contagious impetigo, 136

Contagiousness, 27

Copaiba, eruptions from, 62

Corn, 156

Cornu cutaneum, 158, 159
humanum, 159

Crab-louse, 275

Creeping disease, 278

Crusta lactea, 104

Crustae, 24

Crusts, 24

Cubebs, eruptions from, 62

Culex, 279

Cuniculus, 268

Curette, 208

Cutaneous calculi, 42
horn, 158

Cutis anserina, 152
pendula, 176

Cyst, sebaceous, 43

Cysticercus cellulosae, 276

Dandruff, 33, 34

Darier's disease, 153

Defluvium capillorum, 181

Demodex folliculorum, 40

Depilatories, 169

Dermalgia, 244

Dermatalgia, 244

Dermatitis, 58-64
acute general, 96
ambustionis, 58
blastomycetic, 266
calorica, 58
congelationis, 58
contusiformis, 50
exfoliativa, 96, 97
general, 96
neonatorum, 97
recurrent, 96
factitia, 64
gangraenosa, 65
herpetiformis, 83-86
iodoform, 59
malignant papillary, 240
medicamentosa, 60
papillaris capillitii, 135
repens, 81
traumatica, 58
vegetans, 142
venenata, 59
_x_-ray, 63

Dermatographism, 52

Dermatolysis, 176

Dermatomyoma, 196

Dermatosclerosis, 172

Dermatosyphilis, 213

Dhobi itch, 265

Digitalis, eruptions from, 62

Disorders of the glands, 28-44

Dissection wound, 73

Distribution and configuration, 24-26

Drug eruptions (dermatitis medicamentosa), 60

Duhring's disease, 83

Dysidrosis, 76

Ecthyma, 138, 139

Eczema, 100-119
erythematosum, 102
fissum, 106
impetiginosum, 104
madidans, 105
marginatum, 253
papulosum, 103
pustulosum, 104
rimosum, 106
rubrum, 105
sclerosum, 106
seborrhoicum, 33, 34, 91, 95, 109
squamosum, 104
verrucosum, 106
vesiculosum, 104

Electrolysis in removal of hair, 169

Elephant leg, 174

Elephantiasis, 174-176
Arabum, 174
Graecorum, 231

Epidermis, 18

Epidermolysis bullosa, 80

Epilating forceps, 249

Epithelial cancer, 236

Epithelioma, 236-240
benign cystic, 198
molluscum, 153

Equinia, 74

Erasion, 208

Eruptions, feigned (artificial), 64
medicinal (dermatitis medicamentosa), 60

Erysipelas, 66, 67
ambulans, 67
migrans, 67

Erysipeloid, 67

Erythema, 44
annulare, 48
bullosum, 48
caloricum, 44
desquamative scarlatiniform, 96
gangrenosum, 65
gyratum, 48
induratum, 51
scrofulosorum, 51
intertrigo, 45, 46
iris, 48
marginatum, 48
multiforme, 46
nodosum, 50, 51
recurrent exfoliative, 96
simplex, 44
solare, 44
traumaticum, 44
venenatum, 44
vesiculosum, 48

Erythrasma, 265

Excessive sweating (hyperidrosis), 28

Excoriationes, 24

Excoriations, 24

Farcy, 74

Favus, 247
of general surface, 248
of nails, 249
of scalp, 247

Feigned eruptions, 64

Fever blisters, 78

Fibroma, 192-194
molluscum, 192

Fibromyoma, 196

Filaria, 175
medinensis, 277

Fish-skin disease, 165

Fissures, 24

Flea, common, 279
sand, 278

Flesh worms, 38-41

Folliclis, 130

Folliculitis barbae, 130
decalvans, 131
pustular, conglomerate, 252

Forceps, epilating, 249

Fragilitas crinium, 187

Framb[oe]sia, 73

Freckle, 148

Frost-bite, 58

Fungous foot of India, 212

Furuncle, 68

Furunculosis, 69

Furunculus, 68-70

Gad-fly, 278

Galvano-cautery, 208
instruments, 206

Gangrene of the skin (dermatitis gangraenosa), 65
spontaneous, 65
symmetric, 66

Gelatin dressing, 116

Giant urticaria, 54

Glanders, 74

Glands, sebaceous, 33
sweat, 28

Glossy skin, 189

Gnat, 279

Goose-flesh, 152

Granuloma fungoides, 242
necroticum, 129

Grayness of the hair, 180

Grutum, 42

Guinea-worm, 277

Gumma, 225

Gun-powder marks, 151

Gutta-percha plaster, 117

Hair, 21
atrophy of, 187
graying of, 180
hypertrophy of, 168
superfluous, 168

Hair-follicle, 21

Hairy people, 168

Harvest mite, 277

Heat rash, 74

Hemorrhages, 144-146

Henoch's purpura, 145, 146

Hereditary infantile syphilis, 228
cutaneous manifestations of, 221

Herpes, 78
facialis, 78
gestationis, 83
iris, 48
labialis, 78
praeputialis, 79
progenitalis, 78
simplex, 78-80
zoster, 81-83

Hirsuties, 168

Hives, 52

Homines pilosi, 168

Horn, cutaneous, 158

Hydradenitis suppurativa, 130

Hydroa aestivale, 80
herpetiforme, 83
puerorum, 80
vacciniforme, 80

Hydrocystoma, 31

Hyperesthesia, 244

Hyperidrosis, 28-30

Hypertrichosis, 168-170

Hypertrophic scar, 192

Hypertrophies, 148-177

Hypertrophy of the hair, 168
of the nail, 167

Ichthyosis, 165-167
congenita, 165
follicularis, 153
hystrix, 165
sebacea, 33
cornea, 153
simplex, 165

Impetigo contagiosa, 136, 138
herpetiformis, 138
simplex, 137

Infantile syphilis, hereditary, 228

Inflammations, 44-143

Inflammatory fungoid neoplasm, 242

Iodides, eruptions from, 62

Iodoform dermatitis, 59

Itch, 267
barbers', 255
dhobie, 265
mite, 269

Ivy poisoning, 59

Ixodes, 277

Jigger, 278

Keloid, 172, 192
cicatricial, 191
false, 191
of Addison, 172
of Alibert, 191
spontaneous, 191
true, 191

Keratodermia, symmetric, 155

Keratoma, 155

Keratosis follicularis, 153
palmaris et plantaris, 155
pigmentosa, 160
pilaris, 151, 152
senilis, 236

Kerion, 255

Land scurvy, 145

Larva nigrans, 278

Lentigo, 148

Leontiasis, 233

Lepra, 231-235

Leprosy, 231
anaesthetic, 233
Lombardian, 235
tubercular, 232

Leptus, 277

Lesions, 22
configuration of, 24
consecutive, 23
distribution of, 24
elementary, 22
primary, 22
secondary, 23

Leucoderma, 178

Leucopathia, 178

Lichen moniliformis, 98
pilaris, 151
planus, 98
hypertrophicus, 98
ruber, 99
acuminatus, 99
scrofulosus, 100
tropicus, 74
urticatus, 53

Linae albicantes, 190

Linear naevus, 163
scarification, 208

Liomyoma cutis, 196

Liquor carbonic detergens, 113
picis alkalinus, 116

Lombardian leprosy, 235

Louse, body (pediculus corporis), 274
clothes (pediculus corporis), 274
crab, 275
head (pediculus capitis), 272

Lousiness, 271

Lupoid acne, 129
sycosis, 131

Lupus, 203
erythematodes, 199
erythematosus, 199-203
exedens, 203
exfoliativus, 203
exulcerans, 203
hypertrophicus, 204
sebaceous, 199
ulcerations, 203
verrucosus, 204
vorax, 203
vulgaris, 203-208

Lymphangiectodes, 198

Lymphangioma, 198
tuberosum multiplex, 198

Lymphangiomyoma, 196

Maculae, 22
et striae atrophicae, 190

Macules, 22

Madura foot, 212

Malignant papillary dermatitis, 240
pustule, 72

Medicinal eruptions (dermatitis medicamentosa), 60

Melanoderma, 149

Melanosarcoma, 242

Melasma, 149

Mercury, eruptions from, 62

Microsporon audouini, 258

Microsporon furfur, 262
minutissimum, 265

Miliaria, 74-76
alba, 75
crystallina, 30
rubra, 74

Milium, 42, 43
needle, 42

Milk crust, 104

Mite, harvest, 277
itch, 269

Moist papule, 216, 217

Mole, 162

Molluscum contagiosum, 153
epitheliale, 153-155
fibrosum, 192
sebaceum, 153

Morphia, eruptions from, 63

Morph[oe]a, 172

Mosquito, 279

Mucous patch, 217

Mycetoma, 212

Mycosis fungoides, 242

Myoma, 196
cutis, 196
telangiectodes, 196

Naevus araneus, 198
capillary, 196
flammeus, 196
linear, 163
lipomatodes, 164
pigmentosus, 162
pilosus, 163, 168
sanguineus, 196
simplex, 196
spider, 198
spilus, 163
tuberosus, 197
vasculosus, 196
venous, 197
verrucosus, 163

Nail, atrophy of, 188
hypertrophy of, 167

Necrotic granuloma, 129

Neoplasm, inflammatory fungoid, 242

Neoplasmata (new growths), 191, 241

Nettlerash, 52

Neuralgia of the skin, 244

Neuroma, 194

Neuroses, 244-247

New growths, 191-243

Nits, 273

Objective symptoms, 22

[OE]dema, acute circumscribed, 54
neonatorum, 170

[OE]strus, 278

Ointment bases, 27

Onychatrophia, 188

Onychauxis, 167, 168

Onychomycosis, 188
favosa, 249

Opium, eruptions from, 63

Oroya fever, 73

Osmidrosis, 32

Ova of pediculi, 273

Pachydermia, 174

Paget's disease of the nipple, 240

Papillae, nervous and vascular, 20

Papulae, 23

Papule, moist, 216, 217

Papules, 23

Parasitic affections, 247-279
sycosis, 255

Parasiticides, 250, 259

Parchment skin, 190

Paronychia, 167

Patch, mucous, 217

Pediculosis, 271
capillitii, 272
capitis, 272, 273
corporis, 274, 275
pubis, 275, 276

Pediculus capitis, 272
corporis, 274
pubis, 275
vestimenti, 274

Peliosis rheumatica, 144

Pellagra, 235

Pemphigus, 140-144
foliaceus, 141
neonatorum, 140
pruriginosus, 83
vegetans, 142
vulgaris, 140

Perforating ulcer of the foot, 213

Peruvian warts, 73

Phlegmona diffusa, 68

Phosphorescent sweat, 33

Phosphoridrosis, 33

Phtheiriasis, 271

Plan, 73

Pityriasis capitis, 34
maculata et circinata, 95
pilaris, 151
rosea, 95, 96
rubra, 97

Pityriasis rubra pilaris, 99
versicolor, 261

Plasment, 117

Plaster-mull, 117

Podelcoma, 212

Poison dogwood, dermatitis from, 59
ivy, dermatitis from, 59
sumach, dermatitis from, 59
vine, dermatitis from, 59

Pomphi, 23

Pompholyx, 76-78

Port-wine mark, 197

Post-mortem pustule, 73

Prickly heat, 74

Primary lesions, 22, 23

Prurigo, 118, 119

Pruritus, 244-247
ani, 245
hiemalis, 245
scroti, 245
senilis, 245
vulvae, 245

Pseudochromidrosis, 33

Psoriasis, 86-95
circinata, 88
diffusa, 88
guttata, 88
gyrata, 88
inveterata, 88
nummularis, 88
punctata, 88
syphilitica, 218

Psorospermosis, 153, 154, 240

Pulex irritans, 279
penetrans, 278

Punctate scarification, 208

Purpura, 144-146
haemorrhagica, 145
Henoch's, 145, 146
rheumatica, 144
scorbutica, 146
simplex, 144
urticans, 144

Pustula maligna, 72

Pustulae, 23

Pustules, 23

Quinine, eruptions from, 63

Rapidity of cure, 27

Raynaud's disease, 66

Recurrent summer eruption, 80

Red chromidrosis, 33
gum, 74

Relative frequency, 26

Rhagades, 24

Rheumatism of the skin, 244

Rhinophyma, 127

Rhinoscleroma, 198, 199

Rhus poisoning, 59

Ringworm, 251
of bearded region, 255
of general surface, 251
of the nail, 253
of the scalp, 253
of the thighs and scrotum, 252
Tokelau, 261

Rodent ulcer, 236

Rosacea, 198
acne, 126

Rubber plaster, 117

Rupia, 221, 222

Salicylic acid, eruptions from, 63
paste, 113

Salt rheum, 100

Sand flea, 278

Sarcoma, 241, 242
cutis, 241

Sarcoptes scabiei, 269

Scabies, 267-271

Scales, 24

Scarification, linear, 208
punctate, 208

Scarifier, multiple, 202
single, 202

Scars, 24
hypertrophic, 192

Schoenlein's disease, 145, 146

Sclerema, 172
neonatorum, 171
of the newborn, 171

Scleriasis, 172

Scleroderma, 172, 173
neonatorum, 171

Scorbutus, 146

Scrofuloderma, 209
pustular, small, 210

Scurvy, 146
land, 145
sea, 146

Sebaceous cyst, 43
gland, 33
tumor, 43

Seborrh[oe]a, 33-38
congestiva, 199
oleosa, 34
sicca, 34

Secondary lesions, 23, 24

Shingles, 81

Skin, anatomy of, 17
cancer, 236
general idiopathic atrophy of, 189
glossy, 189
looseness of, 176

Skin, parchment, 190

Spider naevus, 198

Spiradenitis, 130

Spontaneous gangrene, 65

Spots, 22

Squamae, 24

Stains, 24

Statistics, 280, 281

Steatoma, 43

Steatorrh[oe]a, 33

Stramonium, eruptions from, 63

Striae et maculae atrophicae, 190

Strophulus, 74
albidus, 42

Subjective symptoms, 22

Sudamen, 30, 31

Superfluous hair, 168

Sweat, colored (chromidrosis), 32
glands, 28
phosphorescent, 33

Sweating, excessive, 28

Sycosis, 130-135
coccogenica, 130
non-parasitica, 130
parasitic, 255
vulgaris, 130

Symmetric gangrene, 66
keratodermia, 155

Symptomatology, 22-26

Symptoms, objective, 22
subjective, 22
systemic, 22

Syphilis cutanea, 213-231
early eruptions of, 213
late eruptions of, 214
papillomatosa, 225
hereditary, 227
eruptions of, 227
of the skin, 213-231

Syphiloderm, 213
acne-form, 220
annular, 219
bullous, 222, 228
circinate, 219
ecthyma-form, 221
erythematous, 214, 227
gummatous, 225
impetigo-form, 220
large acuminated-pustular, 220
flat-pustular, 221
papular, 216
lenticular, 216
macular, 214, 227
miliary papular, 215
pustular, 219
non-ulcerating tubercular, 224
palmar, 217, 218
papular, 215, 227
papulo-squamous, 218
plantar, 218
pustular, 219
serpiginous tubercular, 224
small acuminated-pustular, 219
flat-pustular, 220
papular, 215
squamous, 218
tubercular, 223, 224
ulcerating tubercular, 224
variola-form, 220
vegetating, 218

Syphiloderma, 213

Syphiloma, 225

Tar acne, 120

Tattoo-marks, removal of, 151

Telangiectasis, 127, 197, 198

Tetter, 100

Tinea circinata, 251
favosa, 247-251
fungus of, 249
unguium, 249
imbricata, 261
kerion, 255
sycosis, 255
tonsurans, 253
trichophytina, 251-261
barbae, 255
capitis, 253
corporis, 251
cruris, 252
fungus of, 258
unguium, 253
versicolor, 262-265
fungus of, 262

Tokelau ringworm, 261

Traumaticin, 94

Trichophyton, 258

Trichorrhexis nodosa, 187

Tubercles, 23

Tubercula, 23

Tuberculosis cutis, 209-211
of the skin, 203

Tuberculosis verrucosa cutis, 209, 210

Tumor, sebaceous, 43

Tumors, 23

Turpentine, eruptions from, 63

Tyloma, 155

Tylosis, 155

Ulcer, perforating, of foot, 213
rodent, 236

Ulcera, 24

Ulerythema sycosiforme, 131

Uridrosis, 33

Urticaria, 52-56
bullosa, 54
chronic, 53
factitia, 52
haemorrhagica, 54
[oe]dematosa, 54
papulosa, 54
tuberosa, 54
giant, 54
pigmentosa, 59
vesicular, 54

Venereal wart, 161

Verruca, 160-162
acuminata, 161
digitata, 160
filiformis, 160
necrogenica, 211
plana, 160
juvenilis, 160
senilis, 160
vulgaris, 160

Verruga peruana, 73

Vesicles, 23

Vesiculae, 23

Vitiligo, 178-180

Vitiligoidea, 195

Vleminckx's solution, 129

Wart, 160
Peruvian, 73
pointed, 161
venereal, 161

Wen, 43

Wheals, 23

Wood-tick, 277

Wound dissection, 73

Xanthelasma, 195

Xanthelasmoidea, 56

Xanthoma, 195, 196
diabeticorum, 195
multiplex, 195
planum, 195
tuberculatum, 195
tuberosum, 195

Xeroderma, 165

Xeroderma pigmentosum, 190

_X_-ray dermatitis, 63

Yaws, 73

Zona, 81

Zoster, 81

SAUNDERS' BOOKS

--------- on ---------

GYNECOLOGY

and

OBSTETRICS

* * * * *

W. B. SAUNDERS COMPANY

925 Walnut Street Philadelphia

9, Henrietta Street Covent Garden, London

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SAUNDERS' TEXT-BOOKS CONTINUE TO GAIN

The list of text-books recommended in the various colleges again shows a #decided gain for the Saunders publications#. During the present college year, in the list of recommended books published by 164 colleges (the other 23 have not published lists), the Saunders books are mentioned 3278 times, as against 3054 the previous year--#an increase of 224#. In other words, in each of the medical colleges in this country an average of 20 (18-2/5 the previous year) of the teaching books employed are publications issued by W. B. Saunders Company. That this increase is not due alone to the publication of new text-books, but rather to a most gratifying increase in the recommendation of text-books recognized as standards, is at once evident from the following: Ashton's Gynecology shows an increase of 19; DaCosta's Surgery, an increase of 12; Hirst's Obstetrics, 14; Howell's Physiology, 25; Jackson on the Eye, 16; Sahli's Diagnostic Methods, 11; Scudder's Fractures, 11; Stengel's Pathology, 13; Stelwagon on the Skin, 11. These are but examples of similar remarkable gains throughout the entire list, and is undoubted evidence that the #Saunders text-books are recognized as the best#.

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Bandler's

Medical Gynecology

* * * * *

#Medical Gynecology#. By S. Wyllis Bandler, M.D., Adjunct. Professor of Diseases of Women, New York Post-Graduate Medical School and Hospital. Octavo of 680 pages, with 135 original illustrations. Cloth, $5.00 net; Half Morocco, $6.50 net.

#JUST READY--EXCLUSIVELY MEDICAL GYNECOLOGY#

This new work by Dr. Bandler is just the book that the physician engaged in general practice has long needed. It is truly _the practitioner's gynecology_--planned for him, written for him, and illustrated for him. There are many gynecologic conditions that do not call for operative treatment; yet, because of lack of that special knowledge required for their diagnosis and treatment, the general practitioner has been unable to treat them intelligently. This work gives just the information the practitioner needs. It not only deals with those conditions amenable to non-operative treatment, but it also tells how to recognize those diseases demanding operative treatment, so that the practitioner will be enabled to advise his patient at a time when operation will be attended with the most favorable results. The chapter on Pessaries is especially full and excellent, the proper manner of introducing the pessary being clearly described and illustrated with original pictures that show plainly the correct technic of this procedure. The chapters on Vaginal and Abdominal Massage, and particularly that on Artificial Hyperemia and Anemia, are extremely valuable to the practitioner. They express the very latest advances in these methods of treatment. Hydrotherapy, especially the Ferguson and Nauheim baths, are treated _in extenso_, and Electrotherapy receives the full consideration its importance merits. Pain as a symptom and its alleviation is dealt with in an unusually practical way, its value as an aid in diagnosis being emphasized. Gonorrhea and Syphilis and their many complications are treated in detail, every care being taken to have these sections--of special interest to the practitioner--complete in every particular. Other chapters of great importance are those on Constipation, Sterility, Associated Nervous Conditions in Gynecology, and Pregnancy and Abortion.

Kelly and Noble's Gynecology

and Abdominal Surgery

#Gynecology and Abdominal Surgery#. Edited by Howard A. Kelly, M.D., Professor of Gynecology in Johns Hopkins University; and Charles P. Noble, M.D., Clinical Professor of Gynecology in the Woman's Medical College, Philadelphia. Two imperial octavo volumes of 900 pages each, containing 650 illustrations, mostly original. Per volume: Cloth, $8.00 net; Half Morocco, $9.50 net.

BOTH VOLUMES NOW READY

WITH 650 ORIGINAL ILLUSTRATIONS BY HERMANN BECKER

AND MAX BROEDEL

In view of the intimate association of gynecology with abdominal surgery the editors have combined these two important subjects in one work. For this reason the work will be doubly valuable, for not only the gynecologist and general practitioner will find it an exhaustive treatise, but the surgeon also will find here the latest technic of the various abdominal operations. It possesses a number of valuable features not to be found in any other publication covering the same fields. It contains a chapter upon the bacteriology and one upon the pathology of gynecology, dealing fully with the scientific basis of gynecology. In no other work can this information, prepared by specialists, be found as separate chapters. There is a large chapter devoted entirely to _medical gynecology_, written especially for the physician engaged in general practice. Heretofore the general practitioner was compelled to search through an entire work in order to obtain the information desired. _Abdominal surgery_ proper, as distinct from gynecology, is fully treated, embracing operations upon the stomach, upon the intestines, upon the liver and bile-ducts, upon the pancreas and spleen, upon the kidney, ureter, bladder, and the peritoneum. Special attention has been given to _modern technic_ and illustrations of the very highest order have been used to make clear the various steps of the operations. Indeed, the illustrations are truly magnificent, being the work of _Mr. Hermann Becker_ and _Mr. Max Broedel_, of the Johns Hopkins Hospital.

Ashton's

Practice of Gynecology

* * * * *

#The Practice of Gynecology#. By W. Easterly Ashton, M.D., LL.D., Professor of Gynecology in the Medico-Chirurgical College, Philadelphia. Handsome octavo volume of 1096 pages, containing 1057 original line drawings. Cloth, $6.50 net; Half Morocco, $8.00 net.

RECENTLY ISSUED--NEW (3d) EDITION

THREE EDITIONS IN EIGHTEEN MONTHS

Three editions of this work have been demanded in eighteen months. Among the new additions are: Colonic lavage and flushing, Hirst's treatment for vaginismus, Dudley's treatment of cystocele, Montgomery's round ligament operation, Chorio-epithelioma of the Uterus, Passive Incontinence of the Urine, and Moynihan's methods in Intestinal Anastomosis. Nothing is left to be taken for granted, the author not only telling his readers in every instance what should be done, but also precisely _how to do it_. A distinctly original feature of the book is the illustrations, numbering about one thousand line drawings made especially under the author's personal supervision from actual apparatus, living models, and dissections on the cadaver. These line drawings show in detail the procedures and operations without obscuring their purpose by unnecessary and unimportant anatomic surroundings.

#Howard A. Kelly, M.D.#

_Professor of Gynecology, Johns Hopkins University._

"It is different from anything that has as yet appeared. The illustrations are particularly clear and satisfactory. One specially good feature is the pains with which you describe so many _details_ so often left to the imagination."

#Charles B. Penrose, M.D.,#

_Formerly Professor of Gynecology, University of Pennsylvania._

"I know of no book that goes so thoroughly and satisfactorily into all the _details_ of everything connected with the subject. In this respect your book differs from the others."

#George M. Edebohls, M.D.#

_Professor of Diseases of Women, New York Post-Graduate Medical School._ "I have looked it through and must congratulate you upon having produced a text-book most admirably adapted to _teach_ gynecology to those who must get their knowledge, even to the minutest and most elementary details, from books."

Webster's

Diseases _of_ Women

* * * * *

#Diseases of Women.# By J. Clarence Webster, M.D. (Edin.), F.R.C.P.E., Professor of Gynecology and Obstetrics in Rush Medical College. Octavo of 712 pages, with 372 illustrations. Cloth, $7.00 net; Half Morocco, $8.50 net.

RECENTLY ISSUED--FOR THE PRACTITIONER

Dr. Webster has written this work _especially for the general practitioner_, discussing the clinical features of the subject in their widest relations to general practice rather than from the standpoint of specialism. The magnificent illustrations, three hundred and seventy-two in number, are nearly all original. Drawn by expert anatomic artists under Dr. Webster's direct supervision, they portray the anatomy of the parts and the steps in the operations with rare clearness and exactness.

#Howard A. Kelly, M.D.#, _Professor of Gynecology, Johns Hopkins University._

"It is undoubtedly one of the best works which has been put on the market within recent years, showing from start to finish Dr. Webster's well-known thoroughness. The illustrations are also of the highest order."

* * * * *

#Webster's Obstetrics#

#A Text-Book of Obstetrics#. By J. Clarence Webster, M.D. (Edin.), Professor of Obstetrics and Gynecology in Rush Medical College. Octavo of 767 pages, illustrated. Cloth, $5.00 net; Half Morocco, $6.50 net.

RECENTLY ISSUED

#Medical Record, New York#

"The author's remarks on asepsis and antisepsis are admirable, the chapter on eclampsia is full of good material, and ... the book can be cordially recommended as a safe guide."

Cullen's

Uterine Adenomyoma

* * * * *

#Uterine Adenomyoma#. By Thomas S. Cullen, M.D., Associate Professor of Gynecology, Johns Hopkins University. Octavo of 275 pages, with original illustrations by Hermann Becker and August Horn. Cloth, $5.00 net.

JUST READY

Dr. Cullen's large clinical experience and his extensive original work along the lines of gynecologic pathology have enabled him to present his subject with originality and precision. The work gives the early literature on adenomyoma, traces the disease through its various stages, and then gives the detailed findings in a large number of cases personally examined by the author. Formerly the physician and surgeon were unable to determine the cause of uterine bleeding, but after following closely the clinical course of the disease, Dr. Cullen has found that the majority of these cases can be diagnosed clinically. The results of these observations he presents in this work. The entire subject of adenomyoma is dealt with from the standpoint of the pathologist, the clinician, and the surgeon. The superb illustrations are the work of Mr. Hermann Becker and Mr. August Horn, of the Johns Hopkins Hospital.

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The American

Text-Book _of_ Obstetrics

Recently Issued--New (2d) Edition

#The American Text-Book of Obstetrics#. In two volumes. Edited by Richard C. Norris, M.D.; Art Editor, Robert L. Dickinson, M.D. Two octavos of about 600 pages each; nearly 900 illustrations, including 49 colored and half-tone plates. Per volume: Cloth, $3.50 net; Half Morocco, $4.50 net.

#American Journal of the Medical Sciences#

"As an authority, as a book of reference, as a 'working book' for the student or practitioner, we commend it because we believe there is no better."

Hirst's

Diseases of Women

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#A Text-Book of Diseases of Women#. By Barton Cooke Hirst, M.D., Professor of Obstetrics, University of Pennsylvania; Gynecologist to the Howard, the Orthopedic, and the Philadelphia Hospitals. Octavo of 745 pages, 701 illustrations, many in colors. Cloth, $5.00 net; Half Morocco, $6.50 net.

RECENTLY ISSUED--NEW (2d) EDITION

WITH 701 ORIGINAL ILLUSTRATIONS

The new edition of this work has just been issued after a careful revision. As diagnosis and treatment are of the greatest importance in considering diseases of women, particular attention has been devoted to these divisions. To this end, also, the work has been magnificently illuminated with 701 illustrations, for the most part original photographs and water-colors of actual clinical cases accumulated during the past fifteen years. The palliative treatment, as well as the radical operative, is fully described, enabling the general practitioner to treat many of his own patients without referring them to a specialist. The author's extensive experience renders this work of unusual value.

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OPINIONS OF THE MEDICAL PRESS

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#Medical Record, New York#

"Its merits can be appreciated only by a careful perusal.... Nearly one hundred pages are devoted to technic, this chapter being in some respects superior to the descriptions in many text-books."

#Boston Medical and Surgical Journal#

"The author has given special attention to diagnosis and treatment throughout the book, and has produced a practical treatise which should be of the greatest value to the student, the general practitioner, and the specialist."

#Medical News, New York#

"Office treatment is given a due amount of consideration, so that the work will be as useful to the non-operator as to the specialist."

Hirst's

Text-Book of Obstetrics

New (5th) Edition, Revised

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#A Text-Book of Obstetrics#. By Barton Cooke Hirst, M.D., Professor of Obstetrics in the University of Pennsylvania. Handsome octavo, 899 pages, with 746 illustrations, 39 in colors. Cloth, $5.00 net; Sheep or Half Morocco, $6.50 net.

RECENTLY ISSUED

Immediately on its publication this work took its place as the leading text-book on the subject. Both in this country and abroad it is recognized as the most satisfactorily written and clearly illustrated work on obstetrics in the language. The illustrations form one of the features of the book. They are numerous and the most of them are original. In this edition the book has been thoroughly revised. More attention has been given to the diseases of the genital organs associated with or following childbirth. Many of the old illustrations have been replaced by better ones, and there have been added a number entirely new. The work treats the subject from a clinical standpoint.

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OPINIONS OF THE MEDICAL PRESS

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#British Medical Journal#

"The popularity of American text-books in this country is one of the features of recent years. The popularity is probably chiefly due to the great superiority of their illustration over those of the English text-books. The illustrations in Dr. Hirst's volume are far more numerous and far better executed, and therefore more instructive, than those commonly found in the works of writers on obstetrics in our own country."

#Bulletin of Johns Hopkins Hospital#

"The work is an admirable one in every sense of the word, concisely but comprehensively written."

#The Medical Record, New York#

"The illustrations are numerous and are works of art, many of them appearing for the first time. The author's style, though condensed, is singularly clear, so that it is never necessary to re-read a sentence in order to grasp the meaning. As a true model of what a modern text-book on obstetrics should be, we feel justified in affirming that Dr. Hirst's book is without a rival."

Penrose's

Diseases of Women

Sixth Revised Edition

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#A Text-Book of Diseases of Women#. By Charles B. Penrose, M.D., Ph.D., formerly Professor of Gynecology in the University of Pennsylvania; Surgeon to the Gynecean Hospital, Philadelphia. Octavo volume of 550 pages, with 225 fine original illustrations. Cloth $3.75 net.

JUST ISSUED

Regularly every year a new edition of this excellent text-book is called for, and it appears to be in as great favor with physicians as with students. Indeed, this book has taken its place as the ideal work for the general practitioner. The author presents the best teaching of modern gynecology, untrammeled by antiquated ideas and methods. In every case the most modern and progressive technique is adopted, and the main points are made clear by excellent illustrations. The new edition has been carefully revised, much new matter has been added, and a number of new original illustrations have been introduced. In its revised form this volume continues to be an admirable exposition of the present status of gynecologic practice.

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PERSONAL AND PRESS OPINIONS

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#Howard A. Kelly, M.D.,#

_Professor of Gynecology and Obstetrics, Johns Hopkins University, Baltimore._

"I shall value very highly the copy of Penrose's 'Diseases of Women' received. I have already recommended it to my class as The Best book."

#L.E. Montgomery, M.D.,#

_Professor of Gynecology, Jefferson Medical College, Philadelphia._