248 PHYSIC 



far from knowing, and, hence, we accentuate the necessity 

 of obtaining clearer views and notions of the "essential 

 conditions" underlying this, as well as all diseased states 

 bearing the title gouty and rheumatic, they being terms 

 which cover a large area of the field of diseased conditions, 

 and which require more care in their use than they have 

 hitherto obtained. 



The later stages and progress of the disease were char- 

 acterised by slight but diminishing recurrences, when 

 disturbances of sensation were felt, followed by the appear- 

 ance, on small detached areas, of slight hyperoemia, with 

 subsequent thickening of the overlying epidermis, and the 

 development of a "brown paper" feel to the finger. 

 This latter phenomenon, as already described, being due 

 to the rupture of the neural coverings of the involved 

 peripheral nerve terminals, or arborisations, and the sub- 

 sequent invasion of the epidermic cell strata by the 

 escaping neurilemmar lymph and nerve plasm, from the 

 white, or medullary, and the axis cylinder substances, along 

 with their ruptured and disintegrating neuro-keratine 

 sheaths, or containing membranes, and thus constituting 

 a limited neuro-dermal keratosis. 



