34 THE MICROSCOPE. 



On the other hand with our progress in pathological knowledge 

 the study of subjective symptoms assumes an important relation not 

 to be overlooked because they have been the hiding place of in- 

 sincere pretenders who have often relegated all skin diseases to that 

 unknown realm "diseases of the blood." It is the purpose of this 

 paper, however, to call attention to those objective symptoms which 

 yield us the pleasure and the profit of correct opinions. It is not 

 my province to discuss the relative value of microscopes or the 

 management of the same as that can be done by those whose 

 opinions are sustained by knowledge and experience in that special 

 department of microscopy. 



Our observations will lead us to consider two conditions : 



I St. Examination of skin lesions in situ. 



2nd. Examination of those parasitic growths which give as a 

 sequence certain skin lesions. Practically eitner is important, but 

 the latter requires more skill and possibly is more helpful to those 

 whom we serve. I desire to remark in passing that in this as in 

 other departments of medicine accuracy of diagnosis is the key to 

 success, and no instrument gives better precision in this than the 

 microscope. 



For examination of the skin /// situ only low powers are requisite 

 with special mountings, while for the other any microscope with a 

 magnifying power of 250 diameters or more will suffice, /'. e. the same 

 instruments which are adequate for fine diagnosis in other depart- 

 ments of medicine, as for instance urinary analysis or pathological or 

 histological investigations. For example Sycosis parasitica or Favus 

 has been treated per orem for months in some cases for years even 

 with no relief, as the least reflection will convince one must be in 

 this case, while the microscope was ready to differentiate and indi- 

 cate the treatment and so diminish the time of recovery, as a rule, 

 to as many days or weeks at most. In many cases a careful exami- 

 nation of the entire surface is necessary for a correct knowledge of 

 the lesion or lesions for one may not be limited to one lesion at 

 the same time. 



For this purpose a good double convex lens of low power 

 may be quite sufficient, but in case a higher power is required I 

 have had mounted in my office by A. Kuhlman, of this city, a 

 monocular (binocular is better,) similar to one used by Dr. Piffard 

 in New York, a cut of which is here kindly furnished by MiuMillan 



