INCIDENCE OF SKIN AFFECTIONS 53 



local diseases orderly in character, and does away with the 

 apparent element of chance or accident as a determinant 

 factor, making the operation of like causes, under like 

 circumstances, to be followed by like results, and intro- 

 ducing into the work of diagnosis, prognosis, and treat- 

 ment a method of exactitude which has not hitherto been 

 conspicuous, but which may be pregnant with great possi- 

 bilities when the subject comes to be studied in proper 

 detail, and becomes fully systematised. In studying in 

 only slight detail the manner and method of the patho- 

 logical evolution of the two first of these disease entities, 

 viz. rodent and cancerous ulcer, we have been struck with 

 the thought that the processes involve the operation of 

 both material and dynamic factors in a more definite way 

 than can usually be discovered in pathological processes 

 generally, and that, in the two alike, the disintegrative, or 

 dynamic factor, predominates over the material, thereby 

 determining the incidence of abnormally active whole 

 tissue disintegration, as distinguished from the normal or 

 physiological disintegration. We have elsewhere argued 

 that this pathological or abnormal tissue waste is due to 

 the escape into the extra-systemic neural textures of nerve 

 energy, with the resultant blighting and final destruction 

 of these textures, and the involved and systemic neural 

 textures themselves, when they become exposed to the 

 traumatic and neurolytic influence of the escaping nerve 

 force. If this be so, as we have little doubt it is, then 

 we have also reason to believe that the nerve energy is 

 being discharged from within, and, therefore, must reach 

 the scene of its destructive work along the afferent chan- 

 nels or sensory nerve trunks, or by "reverse currents" 

 this latter circumstance explaining the destructive effects 

 of the lethal discharge of nerve force through a receiving 

 or sensory instead of a delivering or motor terminal nerva- 

 ture. It is thus a self-destructive influence, exercised by 

 the involved nervature on itself and its surrounding and 

 neighbouring non-nervous structures, during the pre- 

 valence of which the destroyed and disintegrating tissue 

 elements may become a prey to bio-chemical change, 

 bacterial invasion, and pathogenic influence of other 

 kinds, the morbid process supplying materio-dynamic fac- 



