ECZEMA 245 



return of the eczematous nerve disturbance, in the form 

 of intense itching over the areas formerly affected, was 

 experienced, along with a thickening of the cutis, and at 

 one spot over the metacarpal bone of the right thumb at 

 its proximal end, a small amount of a clear translucent fluid 

 was exuded in three separate minute droplets. At this 

 point, the capillary circulation of the skin had undergone 

 no alteration, in the way of congestion or reddening, so 

 that the extravasated fluid could not have come from these 

 vessels whence then could, and did, it come? From 

 one or other of the two sources remaining it, therefore, 

 must have come, i.e. either from the lymphatic channels, 

 or from the inter-neurilemmar spaces of the cutaneous 

 nerves, and from the former of these it was most unlikely 

 to come, inasmuch as these vessels lymphatic pursue a 

 course in the same direction as the blood vessels, and, 

 therefore, have to discharge their contents at their 

 proximal, or trunk, extremities, where stasis and regurgita- 

 tion are obviated by the onward flow of the blood streams, 

 and by the provision within themselves of a complete 

 series of valvular textures, which effectually bar the back- 

 ward flow of their contained lymph, along the lumina of 

 their tubes, passages, and spaces ; moreover, at the distal, 

 or peripheral, extremities of the lymphatic vessels and 

 spaces no great amount of fluid can accumulate, and, there- 

 fore, no appreciable intra-vascular pressure can exist, hence, 

 we must regard exudation from this quarter as impossible. 

 From the latter source, the inter-neurilemmar spaces of the 

 involved nervature of the part, it must have come, there- 

 fore, and come through the overcharging of these spaces 

 by the lymph, or fluid, occupying them, which lymph, or 

 fluid, being derived from, and continuous with, the 

 cerebro-spinal lymph or fluid, and, consequently, emanating 

 from the spinal cavity, had been driven, it may be, by 

 super-normal pressure, through its neurilemmar barriers, 

 on to the cutaneous outer surface, bringing with it, we 

 may conclude, the materies morbi of the disease, from the 

 recesses of that cavity in which it has been hatched and 

 matured by morbid processes at work amid its liquid and 

 solid contents. 



Eczema of this variety and, we may take it, of most 



