Literary Notices. xlix 



Influence of the Nervons System on the SKin.' 



The action of the vaso-motor nerves on the muscular fibres of the 

 blood vessels explains a large number of affections of the skin which 

 are manifested by inflamatory symptoms and trophic changes which 

 have no real connection with real inflamations of the skin, but may 

 be due to toxic influences upon the vaso-motor centres. 



The eruptions of this class, such as exanthemia and erythemata 

 have been called by Auspitz angioneurotic eruptions. 



The author, however, deals with another sort of nervous affec- 

 tions of the skin, which are accompanied by actual alteration of the 

 histological elements of the skin. 



In one case, a young lady 22 years old, the disease was indicated 

 by maculre of an ivory white color surrounded by a border of pink. 

 The edge is not elevated neither is there evidence of inflamation or 

 itching, .but instead a numbness and anaesthesia. This case of 

 lioderma has a history of corea at 4 years, epilepsy at 12 and subse- 

 quently cephlagia and dizziness. 



A case of leucodermia consequent on melancholia and hysteria 

 is also noted. A third and distressing case was one of scleroderma in 

 which the extremities became encased in thick and brittle skin prevent- 

 ign the impairing motion, and causing muscular atrophy. Microscopic 

 examination not having been possible in any of these cases, it may be 

 a question whether specific agents were absent. This case calls to 

 mind another, reported by Dr. Louis Bauer : - 



A little boy suffered from violent paroxysms of hyperesthesia of 

 the feet without much change of temperature, color or appearance 

 otherwise. The attacks set in suddenly, lasting two or three weeks, 

 and were exceptionally accompanied by the appearance of light red 

 macules on the parts affected. On the return of the trouble, after 

 about a week's intermission, it would invariably change its seat to the 

 opposite side in a symmetrical locality. The last instance was an 

 exception when the right accessory nerve area was affected. After a 

 few days, hearing was totally lost. During the. entire period the pa- 

 tient was excessively irritable and excitable. After thirteen months 

 the boy, then about thirteen years old, recovered his hearing as sud- 

 denly and unexpectedly as he had previously lost it. There was no 

 ])ain, even during the period of acerbation, except when the parts 

 were touched. The author is unable to suggest a diagnosis, though 

 confident that the trouble was of central origin. 



1 A, RavogLI. Journ. Am. Med. Assoc, XX, 18. 



''■ A Neurotic Disease without a Prototype. St. Louis Cliniquc, VI, 4. 



