Again, when the eruption was at its height, the eosinophiles reached 12 per cent. of all leucocytes present in four specimens. The disease seems to exhibit the same features of multiformity, re currence, and obstinacy in the natives of India as among white races. Morris Fig. 1 shows two vesicles (V„ V2) which have been formed entirely be neath the epidermis. Macroscopically both vesicles were about the size of a small pin-head. The entire upper half of the corium is the seat of acute inflam mation. S is a sweat-duct; B indicates small blood-vessels, and G is a sebaceous gland.
Fig. 2 shows the stage preceding the formation of the vesicles. Large num bers of eosinophiles (E) are to be seen scattered throughout the papillm.
Fig. 3 shows the first stage in the formation of the vesicles. Immense and Whitfield (Brit. Jour. of Derm., June, '97).
Case of derinatitis herpetiformis in a child, 3 years of age, cured by circum cision. The disease was being kept up by the reflex irritation caused by phirnosis. J. N. Roussel (New Orleans Med. and Surg. Jour., June, 1900).
Pathology. — The pathological his tology of dermatitis herpetiformis has been most thoroughly studied by Gil christ, and the histological characters of the affection are shown in the illustra tions on page 414, representing sections from a case of dermatitis herpetiformis numbers of polynuclear leucocytes are massed in the papillm, having replaced the normal tissue.
Post-mortem in a case. 1. Absence of bacterial specificity in contents of 2. Coincidence noted by Brocq of lesionl of nervous system. 3. Co existence of bullous lesions and nephritis. Gastou (Le Bull. Med., Apr. 21, '95).
Diagnosis.—The multiformity of the lesions and the tendency to their herpetic arrangement, which Duhring regards as characteristic; the chronicity of the dis ease, and its frequent recurrence; the burning and itching, and general ab sence of marked constitutional disturb ance will usually enable a diagnosis to be made without difficulty. Among the dis eases which may cause doubt are pem phigus, herpes, erythema multiforme, and eczema.
PEMPHIGUS.—The lesions are usually well-formed large blebs, rising abruptly tended by moderate pain and burning; no itching; the blisters are usually small and aggregated in groups. The course of the disease is acute.