BY E. W. IRELAND. M.B., CM. oyo 



I have recently had under my care several cases of 

 acne of a persistent character. The first was in a young 

 woman of 25 years, who has suffered with amenorrhoea 

 and dismenorrhoea for several years, and whose face has 

 been greatly disfigured by the skin eruption for the past 

 three years. In March of last year she had a trip to Java, 

 and in the tropics the skin became quite clean, probablv 

 owing to free perspiration carrying away toxins and flush- 

 ing the skin thoroughly. On her return to Australia she 

 had three months' treatment with radium in ^Melbourne, 

 and got back to Hobart at the end of last year free of 

 her rash. The spots began to appear after a month or 

 two, and early in the year I ordered her to bed for a 

 severe attack of pain in the left iHar region — probably 

 ovarian associated with dysmenorrhoea. The patient was 

 very anaemic, with a foul tongue, no temperature, haemic 

 sounds in pulmonary area, and re-duplication of apical 

 sounds. She remained in bed three weeks, and treated the 

 rash with radium; the diet was restricted to milk. For 

 several days nothing but milk was given, a little fruit, but 

 no eg-gs or meat allowed. The general condition 

 improved, and the face became almost quite free of acne, 

 but as spots continually appeared, I made an autogenous 

 vaccine, and injected it a few times. This culture, after 

 twenty-four to forty-eight hours, contained large staphy- 

 lococci alone, but after a week numerous bacilli made 

 their appearance actively mobile, and very Hke the bacillus 

 coli in movements and staining. The patient, after two 

 or three injections, went to Sydney for the winter, and 

 remained free of the acne until lately, when it returned 

 on her arrival in ^ilelbourne. I think that with a longer 

 treatment of autogenous vaccine I should have obtained 

 a perfect result, judging from subsequent experience. The 

 blood was not examined in this instance. 



Since this I have made a routine of blood examination 

 in every case, and have checked the improvement of the 

 patient by the blood picture. 



Another case of acne was in a young girl of 17 years, 

 who had tried state school teaching, but had been 

 obhged to give it up on account of severe headaches, 

 shivering and vomiting attacks occurring at short inter- 

 vals. In this patient the blood showed excess of blood 

 platelets, and many small leucocytes, with a low haemo- 

 globin index, and a general leucocytosis. Some cocci 



