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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    there was something in his research work which was the cause of these attacks, he proceeded to ascertain what it was by a process of exclusion, and, eventually, he proved conclusively that the offending irritant was one single substance—phenyl-hydrazin hydrochloride. A small quantity of this, touching his finger, produced within a few minutes great local irritation, followed by a vesicular eruption, and in a few hours by a severe, widely-spread acute eczema. After removing every trace of this substance from his laboratory, the attacks ceased completely, and although it is now six years ago, they have never recurred. There is not a trace of any eruption on his body at the present time. I have given this case somewhat fully, because of its particularly clear and definite history. Similar cases, however, are of daily occur- rence. Perhaps the most common instance is that of general eczema which so often follows a local varicose ulcer of the leg when it is irri- tated by an unsuitable application. At first the application makes the neighbouring skin on the leg inflamed and angry. Further appli- cations are applied daily, and probably, but not necessarily, the other leg begins to be irritable ; later the arms, neck, and face become itchy, and very soon a symmetrical eczematous eruption appears in those situations without any trace of eruption in the intervening skin. That these distal eruptions are of nervous origin, and possibly of a reflex nature, is probable from their symmetry, their appearance after the application of the irritant, their much milder type, and their frequent disappearance, without local treatment, very soon after the soothing of the originally irritated ulcer of the leg. A similar condition is also common in cases of eczema of the hands,* but it is here often difficult to prove, owing to the many irritants to which both the hands are daily or even hourly exposed. That distal symmetrical eruptions can be produced by a localised irritant alone there is abundant evidence, but, that an irritant, applied * J. F. Payne (loc. tit., p. 511) writes: “ The hands are often affected by various traumatic causes, such as those proceeding from certain occupations— washing, friction of tools, irritating substances, and so forth—that it is difficult to draw the line between traumatic dermatitis and eczema. But when an in- flammation with the characters of eczema spreads beyond the part injured, continues when the irritation has ceased, and tends to become distributed in a typical manner, unrelated to the original seat of injury, and especially if it affect both hands when only one was subject to the trauma, it seems right to call the affection eczema.”