484 DISEASES OF THE SKIN. 



tion does not last ovei two or three weeks, we certainly are warranted 

 in calling it acute ; but, if we choose, we may regard the interval 

 when no blebs form, which often lasts for months, and during which 

 the patient feels as well as before his first attack, as a period of 

 " latence," and call the series of relapses chronic pemphigus. 



Hebra and Cazenave describe a truly horrible malady called 

 pemphigus foliaceus. In this affection a very few, or perhaps only 

 a single bleb forms. They are not as tensely filled as those of other 

 forms of pemphigus, but have a tendency to spread. In pemphigus 

 foliaceus the liquid constantly pushes further and further beneath the 

 epidermis, until finally the entire skin looks as if it were flayed, or 

 else is covered with a brownish-yellow rind. It generally takes a 

 year for the disease to arrive at this pitch of progress. Meantime 

 portions of the skin heal, but only to be attacked anew. The malady 

 always terminates in death. 



TREATMENT. We can only treat the symptoms of pemphigus, 

 since, in spite of the meritorious labors of Bamberger, who has de- 

 tected ammonia hi the recently-passed urine of pemphigus patients, as 

 well as in then* blood and in the contents of the blebs, the cause of 

 the malady, and the nature of the cachexia, or dyscrasia, giving rise 

 to the eruption, are quite unknown. We can merely support the 

 strength of the patient until the disease subsides spontaneously, and 

 can endeavor to postpone his exhaustion and ultimate death as long 

 as possible. As in all similar cases, whatever tends to increase the 

 waste of the organism must be avoided, and every thing must be fur- 

 nished in abundance which can replace what is consumed, or which 

 can retard the consumption of tissue. With regard to external treat- 

 ment, Hebra prohibits the use of baths and ointments as expressly as 

 he does the internal administration of specifics. However, he recom- 

 mends sprinkling of the moist spots with dry vegetable powder, es- 

 pecially lycopodium-seeds. 



OHAPTEK XI. 



flUTIA DERMATITIS, WITH FORMATION OP ISOLATED FLAT VESICLES, 

 FROM WHICH SCABS OF A PECULIAR SHAPE ARE FORMED. 



ETIOLOGY. Rupia, like pemphigus, forms isolated blebs. Those 

 of pemphigus, however, soon burst, while the rupia blebs last longer. 

 Their contents become purulent, and often are bloody, and, after a 

 while, dry up into a scab. Having once formed, the scab is gradually 

 thickened by the addition of fresh exudation, which generally proceeds 

 from ulceration of the deeper parts of the skin, and which also dries 





