ACAEUS SCABIEI. 31 



even, rise up, ana become inflated. No one would liavp supposed 

 that we had to do here with the common itch, if the mites had not 

 been found in it. With regard to the progress of the disease, 

 Boeck states, that the disorder commences with the formation of 

 red spots upon the hands and feet ; the epidermis then becomes 

 covered with scales, and afterwards with thick crusts, first on the 

 extremities, then on the buttocks, on the face, the hairy scalp and 

 the neck, and at the same time the nails begin to degenerate. The 

 crusts can be removed by baths, when the skin appears red 

 beneath them and is quickly regenerated. Lastly, there is 

 found upon the palms of the hands and soles of the feet, on the 

 flexures of the thighs and legs, on the buttocks and elbows, 

 on the hairy scalp and the neck, firmly adhering crusts of 2 3"' 

 in thickness, of a dingy grayish-green colour, and as hard as bark, 

 rendering the extension of the fingers impossible, and the skin 

 beneath them inflamed and moist. The nails formed are an uneven, 

 cartilaginous, yellowish-brown mass; the hairs fall out upon the 

 detachment of the crusts, and bald places remain. The rest of 

 the skin is inflamed, and exhibits brownish-red round spots on the 

 lower extremities, and separate vesicles on the forearms. 



Under the microscope, rnites, mites' eggs, and excrement, im- 

 bedded in epidermic layers, were met with on all the affected parts, 

 but no galleries were found, and the eggs were therefore found 

 without order in the mounds of epidermis and in the callous 

 thickenings crusts of the epidermis inhabited by the mites 

 instead of galleries. All the patients in the same ward, as well 

 as the nurse, were infected with ordinary pustular itch, although 

 here also no galleries were to be found. Subsequent investigations 

 made the last result doubtful, and above all, the observations upon 

 the Continent have diffused light over this disease. 



In his first report (' Wiener Med. Wochenschrift/ xlviii, 1852), 

 Hebra thought that the great uncleanliness, the phlegm, and the 

 indifference to diseases displayed by the Norwegians, were the 

 causes of this form, by allowing the mites to accumulate in masses 

 upon the body, constantly seeking new and more convenient 

 places, and hence even reaching the face. But, according to him, 

 even the migration to spots which mites do not usually attack, would 

 not suffice, if room were not given, by the accumulation of epi- 

 dermis, for the mites and their eggs, in the formation of the 

 wheals, which only consist of an agglutination of these three 

 structures with plastic, hardened lymph. In the January number 



