855 
PATHOLOG Y. 
ations fometimes occur, with a difchnrge of their lymph, 
followed by a hard dry cuticle, which feparates in large 
pieces. In jhis extreme degree, it approaches very 
clofely to the inveterate degree of Lepriafis vulgaris in all 
refpefts ; the only difference being in the form of the 
patches before they coalefce. It is fometimes the ulti¬ 
mate (late of the Pforiafis diffufa ; .and occafionally a fe- 
quel of the Prurigo fenilis. 
e. P. localis: ftationary; and limited to particular or¬ 
gans; as the lips, eye-lids, prepuce, fcrotum, and infide 
of the hands. In the lad form it is peculiarly common 
to (hoe-makers, and artificers in metallic trades, as bra¬ 
ziers, tinmen, and filverfmiths : probably from filth, and 
the irritation of the lubftances they make ufe of. 
“ Several of the varieties are found alfo occafionally as 
fymptoms or fequels of lues, particularly the firft three ; 
but are in every inftance diftinguilhed by the livid or 
chocolate hue of the fcales.” Good, 4.75. 
The fame general plan of treatment is applicable to all 
the different modifications of Pforiafis, the period of its 
duration, and the degree of accompanying pldogofis, be¬ 
ing carefully attended to. In the commencement of the 
eruption, when it appears fuddenly, and the conftitution 
isobvioufly difordered, a moderate antiphlogiftic treat¬ 
ment niuft be purfued. A gentle purgative fhould be 
adminiftered, and the diet made light by abftrafting every 
thing ftimulant. This regimen, indeed, is requifite 
throughout the courfe of the difeafe, which is immedi¬ 
ately aggravated in fympathy with irritation of the fto- 
mach, whether by fpices, fermented liquors, pickles, or 
vegetable acids ; whence the difufe of thefe articles con¬ 
tributes materially to its cure. But, if the conftitution- 
al difturbance has fubfided, the ufe of the fixed alkali, 
combined with fulphur lotum,or with an infufion of cin¬ 
chona, together with tepid wafiling' with fimple water, or 
milk and water, will gradually remove the complaint. 
If the fcaly patches have extended over a confiderable 
part of the body, and have affumed a more inert and 
chronic charafter, it muft be viewed in a fimiiar light 
with the Lepriafis, and the remedies recommended for 
the firfi: and fecond varieties of that difeafe muft be re- 
forted to. 
The (hooting and burning pain and itching, in the 
early and more inflammatory ftages of Pforiafis, induce 
the patient to feek anxioufly for relief from local exter¬ 
nal applications ; but he is mortified to find that even 
the mildeft fubftances prove Irritants, and aggravate his 
diftrefs. A decoftion of bran; a little cream, or oil of 
almonds, fometimes produce eafe; but any admixture, 
even of the oxyd of zinc, or preparations of lead, with 
thefe liniments, is commonly detrimental. But the more 
local, and lefs inflammatory, eruptions of Pforiafis are 
confiderably alleviated by local expedients. The pfo¬ 
riafis affefting the hands, the fcrotum, or the eye, are re¬ 
lieved by the ung. hydrargyri praecipitati albi, or ung. 
hyd. nitrat. diluted according to the irritability of the 
(kin ; but great care is requifite to keep the parts clean 
by frequent ablution, and to prevent attrition. When 
the difeafe affefts the lips, nothing acrid can be borne 5 
and much of the cure depends upon fee 11 ring the parts 
from irritation, even from heat and cold, by a conftant 
covering of fome mild ointment or plafter. In all thefe 
cafes, fome of the internal remedies above mentioned 
muft be at the fame time employed, according to the 
period and other circumftances of the difeafe. 
4. Lepidofis ichthyofis, or fi(h-fkin : thick indurated 
incruftation, encafing the (kin to a greater or lefs extent. 
It has fome tendency to fealinefs, but without the deci¬ 
duous exfoliations, the diftinft and partial patches, or the 
conftitutional diforder, which belong to lepra and pforia¬ 
fis. There are three varieties. 
a. I. fimplex : in its commencement this difeafe exhi¬ 
bits merely a thickened, harfli, and difcoloured, date of 
the cuticle, which appears, at a little diftance, as if it 
were foiled with mud. When further advanced, the 
Vol. XIX. No. 1308.. 
thicknefs, hardnefs, and roughnefs, become much great¬ 
er, and of a warty character, and the colour is nearly 
black. The roughnefs, which is fo great as to give a 
fenfation, to the finger palling over it, like the furface of 
a file, or the roughed fliagreen, is occafioned by innume¬ 
rable rugged lines and points, into which the furface is 
divided. Thefe hard prominences, being apparently 
elevations of the common lozenges of the cuticle, ne- 
cefiarily differ in their form and arrangement in different 
parts of the body, according to the variations of the c-u- 
ticular lines, as well as in different ftages and cafes of the 
complaint. Some of them appear to be of uniform thick¬ 
nefs from their roots upwards ; while others have a fhort 
narrow neck, and broad irregular tops. The former oc¬ 
cur where the (kin, when healthy, is loft and thin ; the 
latter where it is coarfer, as about the olecranon and pa¬ 
tella, and thence along the outfide of the arifis and 
thighs. On fome parts of the extremities, however, ef- 
pecially about the ankles, and fometimes on the trunk 
of the body, thefe excrefcences are fcaly, flat, and large, 
and occafionally imbricated like the fcales of carp.. In 
other cafes, they have appeared feparate, being interfered 
by whitifh furrows.” The above defeription, and the 
delineation on Plate IX. fig. 1. are from Dr. Bateman’s 
fplendid work. 
This unfightly difeafe appears in large continuous 
patches, which (ometimes cover the greater part of the 
body, except the flexures of the joints, the inner and up¬ 
per part of the thighs, and the furrow along the fpine. 
The face is feldom affefted, but the whole (kin is in an 
extremely dry and unperfpirable condition, and in the 
palms of the hands and foies of the feet it is much 
thickened and brittle. The difeafe often commences in 
childhood, and even in early infancy ; and is in various 
inftances hereditary. The only medicines which feem 
ufeful are pitch and arfenic : the former, however, muft be 
taken in immoderate quantities- Dr. Bateman had a pa¬ 
tient who took half an ounce daily, with much amend¬ 
ment. Sulphureous baths, and rubbing with a rough 
cloth afterwards, will often bring off the fcales ; and, as 
thefe are not foon reproduced, it is a very important pal¬ 
liative meafure. Impreffed with this faft, Dr. Willan re¬ 
commends us to pick them off carefully with the nails 
from any part of the body, while it is immerfed in hot 
water. He fays, “The layer of cuticle, which remains 
after this operation, is harfli and dry ; and the (kin did 
not, in the cafes I have noted, recover its ufual texture 
and foftnefs; but the formation of the fcales was pre¬ 
vented by a frequent ufe of the warm bath, with mode¬ 
rate friftion.” 
( 3 . I. cornea. Several cafes of a rigid and horny (late 
of the integuments, fometimes partial, but fometimes ex¬ 
tending nearly over the whole body, have been recorded by 
authors; fee Phil.Tranf. N° 176. N° 297. and vol. xlviii. 
pt. ii. p. 580. Alfo Zacut. Lufitan. Prax. Hift. obf. i 3 S. 
Ephem. Acad. Nat. Cur. dec. i. p. 89. and occafionally 
fuch a condition of the cuticle has been accompanied 
with the aftual produftion of excrefcences of a horny 
texture. Thefe, how'ever, are rare occurrences. 
y. I.cornigera: with horn-likeincurvaied fproutings; 
fometimes periodically (lied and reproduced. This dif¬ 
eafe appears to have nothing to do with Ichthyofis; the 
horn ufually grows from a wart or tumour; and, if cut 
off, is reproduced. Hence the only mode of cure is to 
extirpate it from its roots. 
Genus V. Ecphfyjis, [from extphvfy, to boil or bubble 
up or over; importing veficular eruption confined in its 
aftion to the furface.] Blains. Orbicular elevations of 
the cuticle containing a watery fluid. There are four 
fpecies, and many varieties. 
1. Ecphlyfis pompholyx, blebs : eruption of blebs con¬ 
taining a reddifii, tranfparent, fluid ; moftly diftinft ; 
breaking and healing without fcale or cruft. They are 
diftinguifhed from Pemphigus by the abfence of fever, 
4 Y and 
