BY E. W. IRELAND, M.B., CM. 37 j 



co-incident with acute nephritis; bronchitis, pericarditis, 

 arthritis, or aHmentary canal complications." Many 

 times, he asserts, operations have actually been performed 

 for supposed appendicitis, intussusception, etc., which 

 would have been avoided by a knowledge of the co- 

 relation of such abdominal symptoms with erythemata. 

 He mentions, amongst other skin eruptions as the outward 

 manifestation of internal disease, syphilitic rashes, itchings 

 of urinary meatus, furunculosis, and ulcerations at the 

 base of nail in diabetes, and the eruptions of fevers. 



For some months before reading this article I have 

 been looking to the condition of the blood stream for an 

 explanation of some skin affections, and for an indication 

 as to what direction treatment of the condition should 

 take. The routine followed is to take a blood smear 

 from the lobe of the ear or linger, and I have found that 

 from an immediate examination of the hanging drop of 

 blood interesting information as to the exact relation of 

 the lesion through the health of the patient may be 

 obtained. 



And in this direction I am convinced more work 

 should be done. By the time a sample of blood has been 

 transferred from the clinician to the bacteriologist, many 

 interesting features to be observed in the fresh blood are 

 lost, and the wonderful check which one has in comparing 

 the fresh blood in the treatment during different stages 

 is missed. 



Alost cases of skin diseases are generally signs of a 

 general discrasia, and signs of this general discrasia may 

 also be seen in an altered condition of the blood plasma 

 and blood corpuscles. 



The improvement of the blood picture as treatment 

 progresses is a most interesting thing to watch, and the 

 simultaneous improvement in the health of the patient 

 shows that normal looking blood is a sufficient and satis- 

 factory index of normal health. 



I am dealing more particularly with skin lesions, the 

 effect of treatment on which can be seen by even the 

 uninstructed. Acne is, I believe, mainly a staphylococcic 

 infection of the skin, primarily due to infection of the 

 blood stream either through the tonsils or through the 

 alimentary tract, which, of course, includes the liver. 



