The histopathology of the diseases of the skin / by P.G. Unna.

  • Unna, Paul Gerson, 1850-1929.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: The histopathology of the diseases of the skin / by P.G. Unna. Source: Wellcome Collection.

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    tion of the eye, the skin is the only organ in which we can compare the histological appearances with the clinical, it is our duty in the interests of the internal organs, clinically hidden from us, so far as possible, to complete the anatomical investigation of the anomalies of circulation in the skin. There is moreover in the skin a whole class of disturbances of circulation, the angio-neuroses, the examination of which is open to us and whose existence in other organs we can only —-as in hysterical affection of the nervous system—suspect. It seems to me then advisable in this chapter on anomalies of circulation even more than in the other, to lay stress not only on the histological aspects but on the gross anatomical, the topographical, and the. clinical, on this last only so far as it may help to clear up our general pathological knowledge of these anomalies. I hope thus not merely to provide a temporary stop-gap for this yawning chasm in our anatomical knowledge, but also by a general marshalling of the mani¬ fold facts, which complicate the investigation, to attract the interest of the pathologist more than formerly to this difficult subject. As indicated in the Preface, I follow a definite arrangement and introduce the special chapter, angio-neurosis, between the chapters hyperaemia and oedema. A. ANEMIA. By anaemia of the skin we understand clinically two totally distinct kinds of pallor of skin, one a true deficiency of blood in the capillaries of the skin, the other a deficiency in its colouring material. This latter, being only a consequence of the general change in the systemic blood, its anatomical investigation must be looked for along with that of the disease of which it is a part (Chlorosis, Leukaemia, Hydraemia, destruction of the blood corpuscles by poison) under the pathology of the blood. We will only occupy ourselves with the quantitative diminution of the blood in the cutaneous vascular system. This is either a manifestation of the diminution of the systemic blood or a condition restricted to the skin. We find the first in acute form in haemorrhage after wounds, in severe intestinal or pulmonary haemorrhage, and in chronic form in loss of blood caused by in¬ testinal parasites and in the advanced stages of cachectic diseases (tuberculosis, cancer), accompanied in these last conditions with definite qualitative changes as well. In these symptomatic anaemias the skin plays in general the role of a regulator, for by the contraction of its vessels the remaining blood is transferred in increased quantity to the vital organs. For this role the skin is more suited than any other organ, for not only are the arteries and veins, during their subcutaneous course, supported by a particularly strong muscular coat, but the colla-