Vol. 60, 1909 - University of North Carolina at Chapel Hill

41f> THE CHARLOTTE MEDICAL JOURNAL.
of suiBcient suprarenal secretion in the cir- may be involved. It is slow in developculation.
If this is so the good results are ment, itches, and is difficult to eradicate,
even more readilv understandable. Both the gouty diathesis and auto-intoxica-
Treatment ol Facial Paralysis Due to ^'""^ been blamed for this condition.
^^"f
Division of .he Facial Nerve.-March
Sudden deaths n. children with such ecze-
"^as must be refeiTed to status lymphat,-
( British Medical Journal) describes two
cases wherein an anastomosis had been per- '^"^ \^'^^' '°
.
«^Pf' « "'^
^^"".f
treatment
of softening the scabs with oi or
formed to correct the facial palsv.
'=«"^'f feline: this
He contends that where the division of vf must be done gradually.
. ., • 1 . ,1 »• t The writer treats weeping surfaces with dithe
nerve is recognized at the time of ope- , ^ , ,. , , r '^
, . r
ration, a careful adjustment of the nerve ^^'^ solutions of alumnuim acetate for sey-
er^l days, following it by a paste of oxide
mav result in a restoration of the functional
^""^^^es
'
activity of the parts. Where division is not °/ ',
the^Z' hands to prevent "f scratching. "V u X;
so recognized, he recommends an early atadded
in slowly healing cases,
'.« tempt at an adiustmentof the ends, opening ^^^ff
the wound for this purpose. In the case ^^'P^"'' "' '^^ seborrhoic forms. Bismuth,
where an adjustment of the ends has been ^i"c or Lassa s salve is used in dry cases,
I:owIer s solution internally and slight l.xa-
attempted no second attempt should be
^lon are of advan age^ Theamount of food
made within three or four months.
reduced. Barley water
He
may be
favors this adjustment of the nerve "'V^'V/^^
substituted or some of the breast feeding.
ends before any attempt be made to perreasonable
loss m weight need not be
form an anastomosis with either the hypo- f^
„i^^ 1 ^^ ,„-,u ti,„ .^•., 1 „„ = .„,„ feared. Starchy food should be given in
glossal or with the spinal accessory. , , \- . c ^ ^^
reasonable quantities to infants more than
Constitutional Eczema ol Infants.— Peer four months old; after the sixth month vege-
(Munch. med. Woch. ) calls attention to tables are allowed. Eggs and soups should
chronic eczema occurring oflenest during be avoided under all conditions. The diet
the first few years of life and most commonly which has brought the cure should be conduring
the nursing period. In contradis- tinned for months. In underfed children
tinction to chronic eczema the acute form cutting down of diet is not permitted; the
is frequently a true dermatitis; intertrigo is children should be fattened.
a true dermatitis only if co-existing with a
disposition to eczema. The eczemas of
older children rest oftenest upon a tubercu-
/W 1 /Tll3t/t;ilUllt;UU3-
«.r £>llrin£>/Mi ^
lous base, and a positive tuberculin reaction
may be obtained in almost every case. The ^ '^^^^ Variety ol Cutaneous Discomyreai
chronic eczema is undoubtedly
cosis.
a con-
stitutional disease, but secondary dermal
disturbance is quite common in their course,
The two factors of importance in the devel-
Foulerton, in 1890 ( 15rit. Jour. Dermat.),
showed that conditions resembling actinomycosis
might be produced by a slreptoopmeut
of chronic eczema are an inherited Ihrix. Since then attention has been drawn
disposition and the type of nutrition; either to peculiar lesions evoked by different spoof
them may be the more important. There rotrices, and now Ravant and Piiioy (Ann.
are two forms of chronic eczema to be found; de Dermat. et de Syph., July, 1909, Paris)
the weeping, scale-forming eczema of the record a case with special features, apparhead,
and the disseminated dry form. The eutly due to a discomyces. The patient
first form is found oftenest in fat, pasty was a man of 4,t, who had always lived in
children, but even the healthiest may be Paris. Six weeks before his admission to
affected. It begins in the scalp, spreading hospital, he experienced dull pains in his
to cheeks and ears; it may spread to other arms and limbs, unaccompanied by any
parts of the body; there is very little itching, other symptom. Soon there appeared on
Overfeeding and constipation are common the leg and shoulder subcutaneous and iiiwith
these children and a spontaneous cure tramuscular nodules, painful on pressure.
may be noted, when at the end of the first These, at first small and hard, rapidly inyear
a mixed diet is ordered for the child, creased in volume, new ones showed them-
The second form occurs almost exclusively selves in various parts, while in a short
in artificial fed infants; over- feeding is com- time some suppurated and burst, dischargmon
and the patients are usually pale, thin, ing pus containing blood and clots. Finally
and flabby; chronic nutritional or intestinal other deep lesions ensued, periostitis, ostitis
disturbances are frequent. It manifests and synovitis, as well as large inlra-muscuitself
as discrete, dry, red, desquamating, lar and subcutaneous abjcesses. Round
infiltrating islands: also as papular and the fistulse so produced, the skin assumed
pustular foci. Weeping and scale forma- a dark wine hue, fairly well-defined at its
tion are uncommon; part or all of the body margin, accompanied with some thicken-