EXTRACT XLII. 



ECZEMA. 



ECZEMA, constitutional and acquired, local and general,, 

 may be regarded as largely due to general nerve influence 

 or to the effects of local irritation on certain peripheral 

 nerve terminals in skin or other exposed surfaces produced 

 by their contact with certain substances, such as sugar in 

 the cases of grocers and confectioners. 



In the former, the constitutional or innate variety, the 

 external manifestation of the disease or rash, may be 

 regarded as due to the expulsion of the materies morbi 

 and to the irritant influence it exercises at the peripheral 

 or excretory extremities of the implicated nerves with 

 their related sudoriferous outlets, and the consequent 

 inflammation excited with its attendant serous exudation 

 and vesiculation : while in the latter, the local or acquired> 

 it may be regarded as due to irritation arising from the 

 contact and, it may be, the absorption of the offending 

 saccharine or other substance. 



The latest clinical illustration of this disease occurring 

 in our experience may be cited as a case of the consti- 

 tutional variety, which, in virtue of an accidentally ex- 

 perienced process of counter-irritation, was precipitated 

 or determined, as it were, and diverted into local channels. 



The subject of this attack, a domestic, aged about fifty 

 years, and never particularly robust, being subject to 

 rheumatism and recurring attacks of acute dyspepsia, felt 

 herself "on the eve" of one of these, which was ushered 

 in, on this occasion, by a period of vague general dis- 

 comfort and local itchings, tinglings, and pains extending 



