MEDICAL INTRO |
BOOKS ON OLD MEDICAL TREATMENTS AND REMEDIES |
THE PRACTICAL
HOME PHYSICIAN AND ENCYCLOPEDIA OF MEDICINE The biggy of the late 1800's. Clearly shows the massive inroads in medical science and the treatment of disease.
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ALCOHOL AND THE HUMAN BODY In fact alcohol was known to be a poison, and considered quite dangerous. Something modern medicine now agrees with. This was known circa 1907. A very impressive scientific book on the subject. |
DISEASES OF THE SKIN is a massive book on skin diseases from 1914. Don't be feint hearted though, it's loaded with photos that I found disturbing. |
Part of SAVORY'S COMPENDIUM OF DOMESTIC MEDICINE:
19th CENTURY HEALTH MEDICINES AND DRUGS |
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LEUKEMIA CUTIS; PSEUDOLEUKEMIA CUTIS3
In some cases of leukemia the skin either directly or indirectly shares in the malady. The lesions presented, consisting variously in
1 As to x-ray treatment: Jamieson, Brit. Jour. Derm., 1903, p. 1 (case illustration; disease disappeared from all parts treated); Jamieson and Hute, ibid., 1904, p. 125 (in prefungoid stage; no traces remained); Stainer, ibid., 1903, p. 212 (apparently cured); Marsh, Amer. Jour. Med. Sci., 1903, vol. cxxvi, p. 314-(apparently cured); Ormsby, Medicine, 1903, vol. ix, p. 904, and Hyde and Montgomery, “Diseases of the Skin,” seventh ed., p. 779 (prefungoid stage; plaques would disappear under treatment); Lustgarten, Jour. Cutan. Dis., 1904, p. 185 (case demonstration; patches had almost entirely disappeared, with the exception of a few unrayed spots, for which patient was still under treatment; “a single twenty-minute exposure will produce a dermatitis on any part of the body followed by a complete disappearance of the lesion”; Lustgarten believes a dermatitis should be provoked by the rays); Elliot, ibid., p. 187 (discussion; complete disappearance of all lesions); Carrier, Jour. Cutan. Dis., 1904, p. 73 (case illustration; lesions have entirely disappeared); Bulkley, ibid, (case demonstration; steady improvement); Dubois-Havenith, Presse med. beige, 1904, vol. lvi, pp. 139 and 423 (symptomatically cured); Belot and Bissérié, Arch. d‘electric med., 1904, vol. xiii, p. 855, and translation in Arch Roentg. Ray, 1904-5, p. 139, and Belot, Annales, 1904, p. 588 (eruption practically disappeared under treatment); Markley, Jour. Cutan. Dis., 1905, p. 440 (disappeared); Jackson, ibid., 1906, p. 193 (apparent recovery for more than a year—recurrence and death); Lawrence, “x-Ray Bath,” Jour. Cutan. Dis., 1908, p. 247; Burnside Foster, ibid., 1909, p. 75 (case improving).
2 C. J. White, ibid., p. 195, has recorded an instance of fatal toxemia apparently resulting from the rapid disappearance of the lesions under x-ray treatment; also refers (with résumé and bibliography) to other reported instances of toxemia following the treatment of other neoplastic growths—see also Pancoast’s paper, Univ. Penna. Med. Bull., Jan., 1907.
3 The following papers will be found to cover pretty fully, by review and bibliog raphy, the literature of the leukemias: Pincus, Archiv, 1899, vol. 1, pp. 37 and 177; Nékám, Ueber die leukœmischen Erkrankungen der Haul, 1899, Vose, Hamburg and Leipsiz; Nicolau, Annales, Aug.-Sept., 1904, p. 753, and also in Unna’s “Histopath- ology”; Brunsgaard, Hautkrankheiten bei der myeloiden Leukæmia und der malignent Granulomatose, Arch., March, 1911, cvi (with case report of a fatal leukemia, and a case of lymph-gland tumors with a blood picture of polynuclear leukocytosis; in both cases metastatic skin tumors in the form of cutaneous and subcutaneous papules and nodules; gives a good critical review based largely on the histopathology of the various skin lesions associated with the leukemias and the malignant granulomata; Dubreuilh, “Prurigolymphadénique," Annales, 1905, H. 8-9 (concerning especially cases
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the cases reported, or in some instances as a medley in the same case, of true leukemic tumors (Biesiadecki, Hochsinger and Schiff, and others), dry, and, less frequently, moist, eczema-like areas, often of more or less general distribution, eczematous or lichenoid papules, infiltrated, thick ened, reddish, sometimes pale, areas of skin, with occasionally the lines and folds accentuated (when, on the face presenting an appearance of leontiasis); and in some instances the development of diffuse lymphatic thickening and hypertrophy, with the formation in the lower part of the corium, or subcutaneously, of discrete, crowded, or chain-like pea to cherry-sized or larger, doughy or hard, somewhat flattened nodules. There is usually intense itching, and sometimes a hypersensitive skin, tender upon touch or pressure, or at times spontaneously painful. The eczematous element is variable, being more or less intense at different times or periods, but the tumor-like growths and infiltration are usually persistent and progressive; exceptionally the eczematoid, thickened or lymphatic infiltrations give place to atrophic changes. The face, head, arms, and genital and anal regions are frequently favorite situations for the more extreme developments; the face and head in those of limited development. In some of the cases—those in which there is a medley of tumor formations, eczematoid eruptions, and thickened, infiltrated plaques—the resemblance, as to external appearances, to granuloma fungoides is quite striking,1 but there is rarely any decided tendency to ulceration, and practically none to the formation of the peculiar fungoid growths and ulcers of granuloma fungoides. Exceptionally, the mani festation may be suggestive of a multiple pigmented sarcoma.2 Cases of the other extreme—in which the visible tumor formation is practically wanting, and only the smaller subcutaneous nodules, together with a dry, eczematoid, somewhat shriveled-looking, reddened, slightly scaly skin, are present—may show some resemblance to pityriasis rubra of Hebra. Exceptionally an intense pruritus is the sole associated skin symptom.
Not uncommonly the eczema or eczema-like eruption is the first symptom to which the patient’s attention is called, and such a con dition is usually persistent, with a disposition to infiltrated plaques, and most intractable to treatment. The itching also seems more or less uncontrollable. In other instances the eczema-like symptoms are lacking, the manifestations consisting of from several to large numbers of variously sized, slightly to prominently projecting, soft, doughy, firm, sometimes roughly lobulated tumors, over which the skin may or
characterized by pruritus and pruriginous papules, etc, 2 cases of his own; refer ences); Hazen, “Skin Changes in the Leukæmias and Allied Conditions, “Jour. Cutan. Dis., 1911, p. 521 (based upon 2 cases under his own observation (1 case, notes given by Dr. Strobel), a review of recorded cases, omitting doubtful cases, with brief case notes and bibliography of the leukemias and allied conditions—an exhaustive and helpful paper to those interested).
1 Pelagatti, “Mycosis fungoides und Leukämie,” Monatshefte, 1904, vol. xxxix, pp. 369 and 433 (with histologic cuts), believes granuloma fungoides a leukemia primarily, with skin manifestations secondarily.
2 Rolleston and W. Fox, “A Case of Atypical Myeloid Leukemia with Nodular Infiltration of the Skin,” Brit. Jour. Derm., 1909, p. 377 (case illustrations—4 histoiogic cuts, and references).
LEUKEMIA CUTIS; PSEUDOLEUKEMIA CUTIS 913
may not be movable, and which may be of a normal, pale red, yellowish, or brownish-red color. In these cases the general symptoms of leukemia may have long preceded these cutanenous manifestations. Later the leukemia becomes more profound, and there may also be the de velopment of lymphatic abscesses, with sometimes a tendency to a breaking down of the larger growths, exceptionally into gangrenous ulcers; increasing weakness and prostration of the patient, and finally death.
The histologic characters of the growths have been studied by various observers (Biesiadecki, Hochsinger and Schiff, Kreibich, Pinkus, Nékám, Nicolau, and others). There is found a cellular infiltration in the corium and subcutaneous tissue consisting largely, as is generally conceded, of crowded and heaped-up lymphocytes; although some observers believe the masses are derived from the connective-tissue cells in situ, and others that they arise from the exudation of leukocytes from the blood-current.
Pseudoleukemia Cutis.—Pseudoleukemia, known commonly as Hodgkin’s disease, like leukemia, sometimes presents cutaneous mani festations (lymphadenoma cutis) closely or practically similar to those observed in the latter disease, and already described. Bullous lesions are a rather unusual occurrence.1 It is believed by some observers2 that a pseudoleukemia sometimes develops into a true leukemia.
Diagnosis.—The recognition of the eruptions of the leukemias depends largely upon the recognition of the underlying disease. In tractable eczematous or eczematoid eruption, especially if at all exten sive, with a disposition in places to considerable infiltration, rebellious to treatment, and with a troublesome, persistent, or paroxysmal itching difficult to relieve, should always suggest the possibility of granuloma fungoides, a leukemia cutis, or a pseudoleukemia cutis. Suspicion thus aroused becomes more probable or almost certain if there is any associated tumor formation; and as to leukemia and pseudoleukemia, a careful general examination, as to blood, glands, and internal organs, will usually determine the matter. That there is often a strikingly puzzling likeness in the clinical cutaneous ensemble of these three maladies is to be ad mitted, so much so as to suggest a possible kinship.3
Treatment.—Hopeless as to final outcome as it usually is, a proper general plan of treatment is to be instituted. Billings4 has ob served favorable influence from benzol, but says its use requires caution. As to the cutaneous symptoms, exceptionally amelioration and in one or two instances complete relief followed the administration of arsenic, preferably by hypodermic injection. The x-ray, more especially in
1 Bloch reports, Archiv (“Erythema toxicum bullosum und Hodgkinische Krank- heit”), 1907, vol. lxxxvii, p. 287, a case of associated bullous erythema and Hodgkin’s disease.
2Linser, “Beiträge zur Frage das Häutveranderungen bei Pseudoleukämie,” Archiv, May, 1906, vol. lxxx; Radaeli, “Mykosis fungoides oder Pseudoleukämie cu- tanea,” ibid., July, 1906, vol. lxxx.
31 have met with 3 such puzzling cases in recent years in which the differentiation symptoms were so ill-defined that a positive diagnosis without qualification could scarcely be made; all ended fatally. See also footnote of Pardee and Zeit case, under Granuloma fungoides.
4 Billings, “Benzol in the Treatment of Leukemia,” Jour. Amer. Med. Assoc, Feb. 15, 1913, p. 496 (with pertinent literature references). 58
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pseudoleukemia, has given encouraging results.1 The external manage ment of the eruption and tumors is essentially that advised in granuloma fungoides.
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