DISEASES OF THE SKIN. 



hood. Although the male sex is more predisposed to acne than the 

 female, yet, to the dismay of vain mothers, " a bad complexion " the 

 usual euphemism for acne often disfigures their daughters, at the 

 very time when they are about to be introduced into society. Hence, 

 it can hardly be denied that some connection does really exist between 

 the development of acne and the process which is going on in the 

 sexual system. The laity go further ; and, according as they are 

 inclined to regard mankind from a gloomy or a favorable point of view, 

 they ascribe acne to masturbation or to sexual excess, or else attribute 

 it to excessive chastity and over-continence. 



SYMPTOMS AND COURSE. The most frequent seat of acne is upon 

 the face ; next in frequence it appears upon the back, bosom, buttocks, 

 and upper arms. The disease commences by the reddening and swell- 

 ing of the skin at a circumscribed spot, in the middle of which there is 

 a black point the comedo (acne punctata). If resolution of the 

 inflammation takes place, the swelling subsides in the nodule, the epi- 

 dermis, loosened by the inflammation, scales off, leaving a reddened 

 and somewhat hardened spot which remains upon the skin for some 

 time. After a while, however, this likewise disappears. If the inflam- 

 mation passes on into suppuration, a small pustule forms at the apex 

 of the nodule, and after a while bursts, leaving a yellow scab. In 

 rare instances, the nodule upon which the pustule is situated disap- 

 pears soon after the pustule forms, or else after it bursts ; generally, 

 however, it subsides slowly and gradually. It not unfrequently hap- 

 pens that the cutis surrounding the inflamed follicle is more extensively 

 involved in the inflammation, and, becoming infiltrated, swells, hardens, 

 and acquires a deep-red hue. Inflammation of the skin arising from 

 this cause closely resembles furunculous dermatitis. This may end in 

 resolution, the rounded, flat, broad, elevation of the skin into which the 

 acne nodule has converted itself gradually subsiding, casting off its 

 cuticle, and slowly losing its color; but it frequently terminates in sup- 

 puration. The follicle which in such cases has become loosened from 

 its attachments is discharged just as the dead " core " of a boil is dis- 

 charged, and a scar remains. 



TREATMENT. Acne is quite independent of "impurity of thi 

 blood ; " and the " decoctions of woods " and the laxatives even if 

 they had any real title to their supposed properties as " blood puri 

 fiers " would not be suitable remedies hi this affection. But it is not 

 enough that the physician should merely refrain from prescribing these 

 articles ; he must also warn his patients who usually take them behind 

 his back of the impropriety of so doing. Other internal medication 

 should also be abstained from, as it is useless, and since the treatment by 

 external application is always effective. Great benefit is often obtained 



