Squamous Eczema.

LUCIAN N. YOST, M. D., FAIRMONT, VA.

I desire to report the following case and ask if the editor or any reader can suggest to me anything that might do this case some good.

The case is that of my mother, aged 78, who always had remarkably good health, has raised eight children, all living except one, who died at the age of 22 years, of typhoid fever. I am the youngest, at the age of 37. My mother always lived in the country, and enjoyed an out-door life, last spring, during the month of February, she took to her bed, and has been confined to it, and the room, since that time.

For several years she has had a small patch of eczema on left ankle, which during the last two or three years had given her a great deal of trouble. During the month of February she overheated herself, and was taken down at once with the following symptoms: A fine eruption appeared over the upper extremities and the body, extending all over the body until the whole seemed to be one solid eczematous eruption, which from time to time has been better and worse. The body scales off frightfully, the heart seems to be in pretty fair condition for one of her age, the kidneys are now acting fairly well, but at one time the whole body assumed a general anasarca, but by the use of apocynum, that was soon overcome. The appetite is ravenous, and while we have tried to diet her, yet she seems to grow no better, that is, to remain better. All of her hair has come out, and she will take spells of itching that are frightful; at nigh it seems to be worse.

Now, Doctor, it would be impossible to tell you what all has been done for her. She has been in the hospital for weeks, where we have had the very best care that could be given her, and I have several doctors-of the regular school to see her. Some Say she will get well, and others say not, but none has suggested anything yet that seems to do the case any good, and as she is a dear old-fashioned mother and one that is very dear to all of her children, I write you if you can suggest to us anything that might do the case any good.

I have tried to give you the case as it is. My diagnosis is squamous eczema, and it seems to me to be a typical case in every particular, according to all the text I can find upon the subject.

COMMENT:—The above case is an extreme one and the doctor certainly has my sympathy. I do not feel equal to advising him in this case. I have seen excellent results in the treatment of stubborn cases of eczema, but the chances of a cure in this case are lessened by the age of the patient. For external treatment mild, unirritating, local antiseptics over a given area, closely covered, so as to exclude the air as much as possible, have been of service in my cases.

For internal treatment every condition must be closely considered. I believe for a time rhus tox. will accomplish a good result. Berberis is very important and should be persisted in. I believe that iris, either alone or in conjunction with podophyllum, and perhaps phytolacca, should accomplish a good result also. In the treatment of severe forms of this disease, in babies, I have cured a number of cases by the use of phytolacca, Podophyllum, yellow dock, with the acetate of potassium in one, two or three grain doses every three hours. I like the eliminative effect of the acetate of potassium in feeble cases better than the alterative influence of the iodide.

I am quite confident that half of a grain of the carbonate of iron every two or three hours for twelve or fourteen days would be of material benefit in this case. I have received this suggestion both from Prof. Whitford and Prof. Clark, both of whom use this form of iron in certain intractable skin disorders.

I shall be very glad, indeed, to publish the suggestions of any of our readers who may feel inclined to respond to the doctor's request for suggestions in this exceedingly interesting case.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.