An inquiry into the aetiology of infantile eczema : being a thesis for the Degree of Doctor of Medicine in the University of Cambridge / by Arthur J. Hall.

  • Hall, Arthur John, Sir.
Date:
1905
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Licence: In copyright

Credit: An inquiry into the aetiology of infantile eczema : being a thesis for the Degree of Doctor of Medicine in the University of Cambridge / by Arthur J. Hall. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    or removed ? Why is it that infantile eczema of the ordinary type does not begin, more often, at the stage of weaning, when far more irregularities of diet occur than during the first three months of life ? How does the “ digestive disturbance ” theory explain the fact that severe generalised recurrences of the disease appear after the infant rubs itself, even though there be no change whatever in the diet at the time ? Having thus dealt with the first theory, I shall attempt to show what evidence an analysis of these cases gives for or against the second theory, that of external irritation. And I may here state that I am unable to deny, from personal investigations, the presence of a constant pathogenic organism in all these cases, but that I think it rests with those who support the parasitic theory to demonstrate such, in accordance with the laws of bacteriology. Hitherto the constant presence of such a pathogenic organism in cases of eczema has not, in my opinion, been satisfac- torily demonstrated. And even if it were, I am unable to understand how it alone could satisfactorily explain all the features of an infantile eczema. Certainly not, if we are to suppose that every vesicle, every papule, every patch, of erythema occurring in such cases, is due to local parasitic agency. What, then, is the evidence in favour of external irritation ? It may be stated briefly as follows : 1. In almost every case the eruption commences on some part of the head or face. In the infant, during the first few weeks of life, this is practically the only exposed part, at any rate when out of doors. N.B.—In the adult the head is never, and the face but rarely, the initial site of eczema. 2. The secondary distal eruptions on other parts are, in most cases, of much less severity, and tend to disappear directly the original sites recover, unless they (the former) are irritated. 3. The comparatively constant age at which the eruption appears, about the time when the infant is first released from the more extreme protection which it has received during the first few weeks of life. 4. The greatly increased percentage of cases which begin in the colder months of the year, varying markedly with the temperature