Lectures on clinical surgery. Vol. I. Pt. I. On certain rare diseases of the skin / by Jonathan Hutchinson.

  • Hutchinson, Jonathan, Sir, 1828-1913.
Date:
1878
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Licence: Public Domain Mark

Credit: Lectures on clinical surgery. Vol. I. Pt. I. On certain rare diseases of the skin / by Jonathan Hutchinson. 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.

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    some others is, that my mind has been long imbued with an almost implicit faith in the remedy. I have believed that arsenic could cure pemphigus, and I have never thought of resorting to anything else. If the eruption resisted for a while, I have pushed the remedy, and increased the dose. In a case in this hospital a little girl did not get well until I insisted that the sister of the ward should see the child take her medicine; then the pemphigus vanished. In the case of a patient brought to me by Air. W. W. Edwards, of Bromley, we soon reduced a severe and copious eruption to a very sparing one, and got the woman into good health, but for six months we could not make the bullae wholly disappear. Finally, however, by a considerable increase of dose it got quite well. This was the most intractable case that I have had under care (if I except the one already noticed, which was rapidly fatal). Next, let me say clearly that I do not assert that arsenic will cure pemphigus beyond risk of relapse, but rather wish it to be distinctly understood that the remarkable proneness to relapse when the remedy is suspended, is one of the most positive proofs of its specific efficacy. In many cases the evidence of benefit is apparent within twenty-four hours, and in some, if the remedy be suspended, a relapse will occur within a period almost as short. This is a very remarkable fact, but you will find it illustrated, I think, in several of the cases which I am going to quote. To cure, you must persevere; to prevent relapse after cure, you must persevere. A half-cured case is, accord- ing to my experience, quite certain to relapse directly. Very probably it is this tendency which has induced some prescribers to distrust the drug. Th§ patient may for a day or two have missed his medicine, and out comes the eruption again ; and the surgeon, not being informed of what has happened, concludes that arsenic has failed, and prescribes something else. Precisely what I am suggesting once happened to myself, and it was with considerable difficulty