34 PHYSIC 



a wholesale and compound exfoliation or shedding of the 

 entire external dermal and epidermal matrix. 



All such morbid cutaneous phenomena, like all other 

 morbid phenomena, must, therefore, be regarded as natur- 

 ally determined by anatomical and histological conditions, 

 and physiological hydrostatics and dynamics, so to speak, 

 of a constant and consistent character, and hence requiring 

 a therapeutic and other treatment based on such founda- 

 tions and directed by a strictly scientific use of the laws 

 deducible from them by pathologists and clinicians. Thus 

 alone is it possible to place the almost entirely empirical 

 fabric of dermatological therapeutics on a sound basis, 

 where its practical bearings can be directed on lines capable 

 of leading it into the haven of something akin to, if not 

 entirely accordant with, exact science. 



All that has been stated above applies to the sensory 

 neural aspect and to the afferent, peripheral, or cutaneous 

 terminal nervature ; we, therefore, to complete this study, 

 have still to dispose of the efferent or motor nervature, 

 and the nervi communicant es to the sympathetic. 



The efferent or motor aspect of the systemic nervous 

 system has an equal or equivalent terminal distribution 

 throughout the voluntary musculature with the afferent 

 in its distribution to the skin, and is affected on the same 

 lines as determine the incidence of the morbid affections 

 of the latter, the difference in or between the two cate- 

 gories of affections viz. the sensory and motor being 

 due to their different anatomical and histological terminal 

 structural conditions. The principal difference, therefore, 

 being due to the fact that the sensory nervature sheds 

 itself finally from the periphery of the body, while the 

 motor nervature sheds itself into the voluntary muscula- 

 ture, and, by histological continuity along the tendons 

 and their sheaths, into the periosteal structures, the joints, 

 the proper osseous matrix of the skeleton, the medullary 

 substance of its hollow bones, and the systemic lymphatic 

 spaces generally of the cancellous osseous tissues. 



This absolutely different manner of disposal of residual 

 efferent nerve plasma, in its continual nutritional distri- 

 bution to the musculature and skeleton, entails a corre- 

 spondingly different character and incidence in the 



