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BROMODERMA. PRESENTED BY DR. ELLER. H. D., a man, aged 36, born in the United States, was first seen in the Post-Graduate Skin Clinic Jan. 7, 1929. He had had an eruption for eight years.On the right thigh were several bluish nodules each the size of a dollar, some of which were vegetative. A number had healed, leaving large, flat, bluish scars with velvet-like skin. Other similar nodules were present on the anterior aspect of the legs. The patient had been taking bromides for fourteen years. The Wassermann test was negative. DISCUSSION Dr. Williams: Unless the lesions heal with the omission of bromide and the use of salt, I should like to know the result of mixed treatment. The scars look much like syphilitic scars.Dr. Whitehouse: I agree with the diagnosis. We have had many such patients with large tumors on the lower part of the legs. Phenobarbital

THE MANHATTAN Dermatological Society is in many ways a unique organization. It is the second oldest dermatological society in New York, giving priority to the New York Dermatological Society which, founded in 1869, is the oldest in the world. There was never any real rivalry between the two Societies, and they were conducted on much the same plane. As a matter of fact, of the 55 active members elected to the Manhattan Dermatological Society within this 50 year period, 14 have also been members of the New York Dermatological Society. What the Manhattan Dermatological Society has meant to its members during the 50 years of its existence is evidenced by the fact that there have been only eight resignations during that time.For many years the Manhattan Dermatological Society was probably the most difficult medical society in the world to enter. If a member desired to propose Dr. Doe,

Localized Atopic Eczema (Commissures). Presented by Dr. George M. Lewis.F. K., a woman aged 36, noticed a small fissure in the left corner of the mouth five years ago. Two or three years ago the right corner fissured. Both fissures have been persistent, pruritic, and tender at times and limit the opening of the mouth. There has been some improvement in the summer, but recently the condition has become worse. She has been given two x-ray treatments, two radium treatments, and several courses of therapy with vitamins B and C, without effect.Redness and superficial fissuring extend 3 mm. from both corners of the mouth. There is a thin, irregular, white film over the left buccal mucous membrane. The right mucous membrane shows some whiteness in lines adjacent to the biting edge.A mycologic examination gave negative results.Treatment was started with administration of antihistaminic drugs by mouth

Rosacea-like Tuberculid. Presented by Dr. Wilbert Sachs, New York.R. R., a woman aged 31, was first examined in the dermatology clinic of New York Hospital on Dec. 1, 1950, because of an eruption of four months' duration on the face. This began along the mandibular margins and spread upward to involve the cheeks.There is a diffuse erythematous maculopapular eruption of the lateral thirds of the face, rather sharply demarcated at its borders about the eyes and along the mandibular margin. Some telangiectasia is present. Diascopic pressure reveals typical ``apple-jelly'' nodules.Serologic tests for syphilis gave negative reactions. A roentgenogram of the chest was normal, and the reaction to the tuberculin test was strongly positive in a dilution of 1: 1,000,000.Biopsy of the midcutis and upper cutis showed numerous tubercles composed of small round cells, wandering connective tissue cells, and epithelioid cells. There was an occasional giant cell.

An article entitled "Lupus Erythematosus Profundus (Kaposi-Irgang)" by Harry L. Arnold Jr.1 induces me to call attention again to the symptomatology of lupus erythematosus hypertrophicus et profundus, a disease which, if observed a few times, can never be mistaken for anything else. The clinical picture is uniform, definite and distinctive, as I pointed out in a previous article on the subject.2 Differential diagnosis from Boeck's sarcoid, angiolupoid and other variants is clinically possible and not at all difficult. The only variation in its clinical picture is in the degree of severity of the lesions. It belongs to the classification of the fixed discoid variety of the disease but differs greatly from this in appearance.A typical example of lupus erythematosus hypertrophicus et profundus is characterized by more or less oval or rounded, rather sharply outlined, greatly elevated plateau-like plaques with indurated, rolled borders and a variation

MY REASON for presenting this subject is purely altruistic. I realize that the proper milieu for it would be the centennial celebration of the Association in 1976, but by that time I may be attending a meeting of the Intercelestial Dermatological Congress, under the presidency of Ernest Bazin, and listening to a complicated discussion by Unna, Walter Highman and Andrew R. Robinson as to the microscopic observations in a particular section of skin. I have therefore prepared the following data for the benefit of the man who will have the great honor of presenting this subject again twenty-eight years from tonight.In contemplating the founding of the Association and the achievements of its founders, one is compelled by the very strength of character of the men involved to lay aside the motley and assume the attitude of respect, admiration and love which their superlative work in dermatology compels in

IN 1888 Radcliffe Crocker1 first described a telangiectatic form of lupus erythematosus characterized by symmetric persistent circumscribed patches on both cheeks, which on palpation were decidedly thickened and shot through with dilated blood vessels. The extensor surface of the hands was the seat of patchy persistent erythema, resembling chilblain, which after involution showed atrophic scarring. According to Crocker the patches on the cheek simulated the red paint on a clown's face. Under the term "erysipelas perstans faciei," Kaposi,2 in 1872, also called attention to the deep red patches on the face with purpura preceding the onset of lupus erythematosus acutus disseminatus.For the past thirty-five years, with one exception no articles on the subject have appeared in the Archives of Dermatology and Syphilology, and there are not more than seven unchallenged case reports in that journal. It is not described in the textbooks with the exception of Ormsby's

The signing on Aug. 30, 1934 of articles of agreement and affiliation between the New York Post-Graduate Medical School and Hospital, Columbia University, and the Stuyvesant Square Hospital (formerly the New York Skin and Cancer Hospital) marked an event of importance in American dermatology. The merger was a logical one, as the New York Post-Graduate Medical School and Hospital, one of the oldest graduate schools in the country, and the New York Skin and Cancer Hospital, since its inception the largest dermatologic clinic in America, frequently indulged in the interchange of clinicians and teachers even in their early years. As early as 1885 Dr. George Henry Fox held classes at the New York Post-Graduate Medical School and Hospital for several years before receiving an appointment as professor; and during that time he was an attending physician at the New York Skin and Cancer Hospital and was teaching at the College

One of the great faults of dermatologic nomenclature is the haste with which a new name is coined to designate anomalous symptoms of a previously well established clinical entity. To make matters even worse, the needless confusion which thereby ensues in the literature is kept up for years by the continued use of a name which in all common sense should have been relegated to limbo shortly after its conception. This holds particularly true of the term periphlebitis nodularis necrotisans, which was first introduced by Philippson1 in 1901. While the term has rarely appeared in the literature, it has done so frequently enough to warrant an analysis of the evidence pro and con to determine whether it is a clinical entity. I believe that I can offer sufficient evidence to prove conclusively that it has no claim as an original dermatosis, and that it is either an aberrant form

An undertaking which eventually proves of extraordinary value to a community almost always experiences great early difficulties and an almost hopeless struggle for continued existence. This was particularly true of the City Hospital. Most of the first forty years of its life were marked by an administration honeycombed with graft, dishonesty and incompetence, which terminated only with the downfall of the Tweed ring in 1874.A notable exception occurred in 1845, when on a temporary wave of reform Dr. W. W. Sanger was placed in charge. Sanger was the author of that classic work "A History of Prostitution," and most of the material forming the basis of this book originated at the City Hospital. How temporary was this reform was proved by the election of the warden of the penitentiaryas Sanger's successor.The squalor and misery of the following years can best be illustrated by an experience related by Dr.

A Case for Diagnosis (Lupus Tumidus? Lupus Pernio? Sarcoid?). Presented by Dr. Max Scheer for Dr. C. K. Good.H. K., a woman aged 40, from the Skin and Cancer Unit of the New York Post-Graduate Medical School and Hospital, was operated on several years ago for an acute mastoiditis; healing was delayed and an acute antral infection was opened through the nose and irrigated. Both antrums have been punctured and irrigated, and the septum has been operated on to make it possible to reach the antrums. The nasal membranes have shown progressive atrophy and atrophic rhinitis, and nodules over the malar eminence have developed. At first it seemed that the nodules might result from the antral infection, and a radical Caldwell-Luc operation was performed. This did not clear up matters as far as the facial nodules were concerned; they increased. Atrophy of the nasal membrane became profound. Lupus

A Case for Diagnosis (Erythroplasia?). Presented by Dr. George C. Andrews.E. F., a man aged 37, states that about seven months ago he noticed slight itching in the coronal sulcus. For two or three months the irritation would flare up and then regress. Last fall the patient observed two macular areas, one on each side of the frenum. These enlarged peripherally. Urologists considered the disorder to be a chronic balanitis resulting from incomplete circumcision. Circumcision was performed again one and one-half months ago; after that the lesions joined in the midline to form one sharply outlined red macular area. There was no induration. Apparently the lesion healed at times as a result of application of bland ointments and then recurred. There was no scaling until one month ago. The Wassermann and the Kahn test were negative. The patient has taken about one tablet of allylisopropyl barbituric acid and aminopyrine

Macular Atrophy. Presented by Dr. David L. Satenstein.C. J. B., a man aged 25, single, from the Skin and Cancer Unit of the New York Post-Graduate Medical School and Hospital, states that he had no dermatosis before the onset of the present disorder. During June 1932 there suddenly appeared on his back about twelve small, somewhat reddish, raised lesions. These gradually increased in size and new ones continued to appear, but none ever disappeared. At present he exhibits about forty lesions, varying in size from ¼ to 1¼ inches (0.61 to 3 cm.) in diameter. They are oval, slightly reddish, sharply defined, raised and soft. Some have wrinkled centers; others are somewhat doughy. There are no subjective symptoms, and the patient's general condition has always been good. The Wassermann test and urinalysis gave negative results.Leukoderma Centrifugum Acquistum. Presented by Dr. David L. Satenstein.J. G., a boy

Psoriasis is an antidote for dermatologists' ego. It is the most vulnerable point in their armor as experts, and it remains the most baffling of dermatoses despite the great advances recently made in dermatology. Dermatologists of today can ill afford to look askance at the masters of yesterday, for except in diagnosis and palliative treatment they have accomplished nothing in the management of this disease.Because of its antiquity, its confusion with leprosy and other dermatoses and the complete lack of progress both in its therapeutics and in the knowledge of its pathogenesis, the disease is of extraordinary interest, historically as well as philosophically. There is scarcely a therapeutic measure or an etiologic factor mentioned today which did not originate in the minds of dermatologists seventy or more years ago. It is passing strange that this apparent checkmate should have occurred in this particular disease. When one considers

In the last quarter of the fifteenth century, while the Italian Renaissance was rapidly gaining momentum, there was born in the old city of Verona, in or about the year 1478, a boy, son of Paolo Filippo and Camilla de Mascarelli. This child, one Girolamo Fracastoro or Fracastorio, as Bruno prefers, was so blest in after-life that one is almost convinced that his destiny was directed by the same gods he so often eulogized in his various poems.His ancestors, the Fracastorii, according to Cartolari's "Noble Families of Verona," were members of the Council from 1406 to 1771. They were distinguished members of their community and possessed considerable wealth. His great-grandfather, Paolo Filippo, a warm supporter of the Venetian conquest, was one of a small group selected to present to the Doge of Venice the keys of Verona, in 1405. The adherence of Verona to Venice, strangely enough, existed until

I BELIEVE that this is the first time that a symposium on the history of dermatology has ever been presented before a medical body. That the Committee on Education of such an important organization as our American Academy of Dermatology and Syphilology decided to present this symposium evidences the growing interest in the history of our specialty and their appreciation of the immense amount of groundwork done by our dermatological forebears, as also the importance of their superlative contributions to the specialty we so greatly love.In order to allay any qualms of jealousy amidst many personal friends living in cities equally important to those mentioned, may I state that it is my impression that the cities of New York, Philadelphia, Boston, and Chicago were designated for this symposium simply because they are the centers of an immense population, and the rapid development of the specialty of dermatology in them was not due to any special group of supermen

NEVOXANTHOENDOTHELIOMA. PRESENTED BY DR. DAVID BLOOM. R. D., a Negro boy aged 2 yr., was seen at the Sydenham Hospital Skin Clinic for the first time in July, 1950, with cutaneous tumors of six months' duration. We were consulted mainly because of a walnut-sized tumor on the vertex which was broadly attached to the scalp, erythematous, and oozing. The other tumors were pea-to-hazel-nut-sized, few in number, and scattered over the scalp and extremities. They were fairly firm and somewhat yellowish and were attached to the skin but not to the underlying tissue.After biopsy of specimens of the large lesion on the scalp and a lesion on the left knee, the latter area became keloidal, and the lesion on the scalp diminished markedly in size and consistency. In the past few months a few new lesions have developed, one on the anterior lateral aspect of the left thigh which appeared

LUPUS ERYTHEMATOSUS: UNFAVORABLE RESPONSE TO GOLD THERAPY. PRESENTED BY DR. ELLER. E. M., a married woman, aged 27, from the Post Graduate Skin Clinic, presented a brownish, erythematous, scaly eruption involving the bridge of the nose and adjoining areas of the cheeks. There had never been any lesions elsewhere. This was a typical lupus erythematosus discoid, of eleven years' duration. She was first seen in August, 1927. Prior to this she had received several types of treatment, including the roentgen ray, radium, carbon dioxide snow, quartz light and iodine with quinine. Atrophy, pigmentation and telangiectasia were present.She was given gradually increasing doses of gold and sodium thiosulphate twice weekly. At the end of the sixth treatment, a severe constitutional as well as a cutaneous reaction occurred, which latter involved the feet, eyes, mouth, lips, chest and face. The senses of smell and taste were greatly impaired, and the voice

LEUKOPLAKIA. PRESENTED BY DR. FOX. W. S., a full blooded negro, aged 45, born in the United States, presented an eruption of the mouth, first noticed two years before presentation. The eruption consisted of grayish white patches of limited extent and moderate infiltration on the central part of the anterior half of the dorsum of the tongue and both commissures. He complained of soreness after eating, drinking and smoking. There was a history of a genital sore twenty-five years before presentation; the Wassermann reaction was strongly positive. The patient had been an inveterate smoker of cigars, cigarets and pipes during his adult life. The teeth were in good condition and he had suffered from indigestion for years. PAGET'S DISEASE OF THE NIPPLE. PRESENTED BY DR. FOX. F. M. W., a woman, aged 68, had suffered from an eruption of the left nipple for the past six years. The lesion of the nipple was smaller than the size of a dime until last summer, when it spread peripherally to form a round area about

MYCOSIS FUNGOIDES. PRESENTED BY DR. WISE. L. S., a single woman, aged 44, a clerk, presented an eruption which had begun as an erythematous pruritic plaque on the lower part of the back two years before presentation. Shortly after, similar red and violaceous, somewhat elevated patches appeared on both thighs from the groins to the knees. More recently, a group of irregular, somewhat firm, flat, discoid lesions developed on the inner aspect of the left upper arm.The eruption consisted of numerous erythematous plaques of irregular outline from 1 to 8 inches (2.5 to 20.32 cm.) in diameter. They were located chiefly on the anterior, outer and inner aspects of the thighs, with scattered lesions on the groins and upper arms, and on both hips. The lesions were elevated, sharply defined and slightly scaly; the color varied from pink to violaceous. In some of the lesions on the thighs, infiltration

Gold, the favorite metal of mankind, formed a part of many formulas of the early alchemists. Years of experimentation were spent in investigating various elements designated by cabalistic signs, in the hope of producing this precious metal synthetically. It also formed an important ingredient in the various "elixirs of life." Paracelsus1 stated that the mingling of the rose-colored blood from the lion and the glue from the eagle forms the philosopher's tincture for which men without number have sought.Dalton2 interpreted this mystic preparation as follows:We should remember that "lion" is one of the cabalistic synonyms for gold, and the "eagle" one of those for tin. If gold be dissolved in nitro-muriatic acid, evaporated and heated and the product dissolved in water, it forms a solution of the terchloride of gold. This was probably the alchemist's "rose colored blood from the lion." On the other hand, protochloride

YAWS. PRESENTED BY DR. HOWARD FOX. E. T., a colored girl, aged 10, was previously presented at the November meeting of the New York Dermatological Society with a case for diagnosis (bromoderma or yaws). Subsequently, the lesions on the face had increased in extent in spite of the fact that she had discontinued taking "cough medicine." The Wassermann test was strongly positive and several examinations of the lesions, after removal of crusts, showed moderately numerous spirochetes (of Spirochaeta pallida type). The diagnosis of bromoderma was apparently incorrect, and the evidence favored yaws rather than syphilis. DISCUSSION Dr. Goodman said that the lesions presented by the patient were typical of the cases of frambesia which he had seen in the tropics. Reference to recent papers from the Philippine Islands would show pictures of similar lesions in patients with yaws. This patient was the second one with tropical yaws shown in this

The place now occupied by the endocrine glands in medicine is of sufficient importance to affect all branches of that science, but it is particularly in dermatology that some of the phases of dysendocrinism manifest themselves. It is therefore necessary for those of us interested in this particular branch of medicine to become thoroughly acquainted with the more common surface signs of endocrine dysfunction, and it is the object of this paper to bring out the major diagnostic points of the more common of these signs as fully as possible, for on a correct interpretation depends much of our therapeusis. Unfortunately, the literature on the internal secretions is so voluminous, and its dermatologic side so little dwelt on, that the author must beg indulgence for any lapses discovered by those of his readers more skilled than he. Another difficulty encountered is the overenthusiasm of many writers on the ductless glands.

This method was first used by Bacelli in 1893, and subsequently by Blaschko, Lewin, Chopping, Lane, Abadie, Campana, and Stoukowwenkoff and others. The method in recent years has apparently fallen into disuse, very few articles on the subject being found in the literature. This may be due to the rather discouraging attitude of Fournier, who looked on the method with disfavor. He is under the impression that a toxic agent, such as mercury, suddenly placed in contact with the endometrium, may possibly exert a deleterious effect on it. His supposition is based on the experiments of Ullman. While Ullman has never seen an animal die after the intravenous injection of large doses of mercury, yet in a few cases in which death occurred later, there were no lesions which would account for the death of the animal, and Fournier reasons that death might have been caused by paralysis of the

There is to me an inexpressible charm in the lives of the good, brave learned men whose only objects have been and are to alleviate pain and to save life.—G. A. Sala.Dr. FOX, as editor of the Archives of Dermatology and Syphilology for the past ten years, has, with his usual sense of fairness and justice and his inexhaustible capacity for work, carried on the onerous and time-consuming duties usually entailed by such a position. That he has been highly successful in this effort is only stating a fact known by the overwhelming majority of the devotees of the celebrated periodical which he nurtured for a decade and which on Jan. 1, 1948 will be seventy-eight years young. In that space of time not a single issue has been omitted. Its list of editors and the members of its various editorial boards read like a "Who's Who in

Scientific dermatology began on Nov. 27, 1801, when the old Hôpital Saint-Louis, in Paris, was officially dedicated to the treatment of cutaneous diseases, with Jean Louis Alibert at its head. It was Alibert and later teachers, such as Beitt, Cazenave, Devergie and Bazin, who were responsible for directing the first faltering steps of American physicians toward the light of dermatologic learning. Barely one hundred years later dermatology in America has attained a commanding position in the entire medical world; it has been given professorships in practically all of the medical colleges, has an independent department—often the largest from the point of view of floor space and attendance—in the leading hospitals, with a number of hospitals completely self contained in all allied branches devoted entirely to dermatology, and has two dermatologic journals, one covering the entire dermatologic field and the other limited to dermatologic research. Up to October 1940 in dermatology

This paper does not pretend to be a biography, an obituary or a eulogy. My sole reason for its presentation is my deep affection for Aitken, which has extended over many years, and I hope that I may make him seem real to those who did not know him and refresh the memories of those who knew him well.In many respects Aitken was an extraordinary person. He was a member of no dermatologic society other than the Section of Dermatology and Syphilis of the New York Academy of Medicine, the sessions of which he attended irregularly and only as a listener. He refused all offices and did little, if any, writing; yet he was considered one of the most eminent clinicians in New York and second to none in diagnostic ability. In my opinion, based on intimate contact with him for twenty years, this seeming neglect of