Clinical study and analysis of 1,000 cases of psoriasis / by L. Duncan Bulkley.

  • Bulkley, Lucius Duncan, 1845-1928.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Clinical study and analysis of 1,000 cases of psoriasis / by L. Duncan Bulkley. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    9/18
    It will be interesting to know more definitely the exact duration of the disease1 in those patients who have become free from the eruption and who have remained without any manifestations; but unfortunately such statistics are extremely diffi- cult to obtain in an office practice and among out-patients, who are seen only during the actual existence of the eruption or who seek advice only as long as they may desire; moreover, a large number of such cases are seen once or twice, generally in consultation. Something more, however, can be learned of the ob- stinancy of the complaint by a consideration of the length of time during which some of the patients were under observation, either for a continued existence of the eruption or for recurrences of the same. This is exhibited in the following table: TABLE IV. DURATION OF OBSERVATION OP 296 PATIENTS WITH PSORIASIS. Duration. Private Patients Public Patients. Total. Male. Female. Total. Male. Female. Total. 1 mo. to 3 mos. 44 24 68 20 27 47 115 3 (. to 6 tt 16 12 28 5 3 8 36 6 tt to 1 yr. 26 15 41 3 1 4 45 1 to 2 yrs. 14 2 16 3 5 8 24 2 t'i to 3 tt 12 6 18 1 1 2 20 3 tt to 4 .i 8 6 14 2 0 2 16 4 tt to 5 tt 3 2 5 0 0 0 5 5 tt to 10 tt 9 11 20 0 0 0 20 •10 tt to 15 tt 9 4 13 0 0 0 13 15 tt to 20 tt 2 0 * 2 0 0 0 2 Total, 143 82 225 34 37 71 296 It is seen here that in a large number of cases, over one half were seen for comparatively short periods of time, less than six months, and in looking at toe notes of these caies we find that quite a proportion of them yielded to treatment and were apparently cured, while of course a large number were lost sight of be- fore any conclusions could be drawn as to the ultimate results of treatment; the remaining half of the cases were seen for varying periods of time, more commonly, however, not in consecutive months or years, but often after a lapse of a greater or less length of time. ' In studying the records of these cases we find that as we advance in the length of time during which the patients had previously had the disease and also that during which they were under treatment, we discover a smaller proportion of the mreceiving permanent benefit, until in many cases which have been for some years under observation and treatment the question of thera- peutics has narrowed itself down to removing recurrent eruptions or preventing their appearance on exposed regions. In some instances, however, careful and continuous treatment has held the eruption almost entirely in abeyance, even for a great number of years, as in the following case: This case, which has been for the longest period of all the cases under obser- vation and treatment, is that of a clergyman now 50 years of age, who was first seen about twenty years ago. The eruption had begun about eight years previous to his first visit, when he was 22 years of age, it appearing first in the scalp. The disease progressed very slowly and did not become very general until four years later. He has spent much time at different mineral springs with varying results; at times the eruption improved greatly but always relapsed into a worse condition. He was also under various medical treatment until the time of his first visit in 1869. He then had a very general psoriasis, and on account of.