ECZEMA 143 



from the rupture of the vesicles either spontaneously 

 or from traumatic causes. 



5. The pustular stage, which results from the 

 transformation into pus of vesicles filled with serum. 

 These pustules often become confluent, producing 

 large suppurating areas. 



6. The scaly stage, which results from the drying 

 up of the exuded matter and the . desquamation of 

 the dead epidermal cells. 



As before stated, it is by no means necessary that 

 the disease pass through all the above stages. An 

 early stage may pass directly into the last, or the 

 eczema may long remain persistently in the same 

 stage. 



Causes. — Eczema is usually set up as the direct 

 result of some external irritant acting upon the 

 skin, such as dust, mud, fleas, lice, too frequent 

 bathing, and the use of soap. Injurious foods and 

 digestive disorders with faulty elimination no doubt 

 act as predisposing causes, but the disease must be 

 attributed to direct local irritation.' 



Symptoms. — In the initial stage, which very often 

 passes unobserved, bright red spots appear, sur- 

 rounded by a hyperemic area. These spots rapidly 

 run together, the affected skin becoming spongy, 

 turgescent, and of a high temperature. The hair 

 in the affected area stands erect, and the skin is 

 tender and irritable. Owing to the patient's efforts 

 to relieve the pruritis, the pustular and scaly stage 

 may immediately be entered upon, but if the disease 

 runs its regular course, small blisters develop from 

 the pimples. By confluence of these vesicles moist 

 and reddened areas of skin are formed from which 

 the hair falls out. These areas are covered with a 

 serous, sero-fibrinous, or even purulent exudate, and 

 are exceedingly sensitive to the touch and show a 

 tendency to spread. 



